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COPYRrCHT DEPOSrr 



THE MOTHER AND THE CHH^D 



CHOOSE AS YOU WILL ! MY CHOICE IS BEST : 
THE LITTLE LIFE ACROSS MY BREAST." 

E. V. Cooke 

"Chronicles of the Little Tot" 



THE MOTHER 



AND 



THE CHILD 



BY 

NORMAN BARNESBY, M.D. 

AUTHOR OP "medical CHAOS AND CRIME " 




MITCHELL KENNERLEY 

NEW YORK AND LONDON 

MCMXIII 






COPYRIGHT 1913 BY 
MITCHELL KENNERLEY 



THE* PLIMPTON -PRESS 
NORWOOD* MASS- U'S'A 



/V< ^«/^ 



il.A357053 



PREFACE 

MY professional experience has shown 
me very plainly that there is great 
need for a book that will give simple 
but sufficient guidance to parents in all the 
duties and perplexities that concern their 
parenthood; a book to which they can turn 
when they are in doubt with regard to any 
ordinary problem affecting their children, 
in early babyhood or in later life. 

I have commenced at the very beginning 
— with the first signs of pregnancy, and the 
measures that should be taken to safeguard 
the well-being of both mother and child. 
There are some, perhaps, who will think that 
I should have started still earlier; that the 
mother's training should commence in her 
girlhood, long before marriage and mater- 
nity. I have touched upon this in my 
chapter on Eugenics, where the part played 
by heredity, environment and early training 
has been indicated. But it seemed well in 



vi PREFACE 

the arrangement of the book to start with 
what will seem to the expectant mother the 
first great crisis in her life — the assurance 
of pregnancy and then the stirrings within 
her of that other little life to come. I have 
told her what to do for herself and for her 
baby, and I have passed on, chapter by 
chapter, to deal with the questions that will 
inevitably arise, in the order in which they 
will have to be dealt with in real life. I 
have told her how to feed her baby; of its 
nursing, its nurses, and its nursery; of the 
diseases to which it will be liable, with the 
most effective treatment that can be given; 
of the nervous afflictions and minor dis- 
orders of childhood; of the simpler opera- 
tions which may become necessary, such as 
the removal of adenoids; of the proper 
training of childhood, as I conceive it; and 
of such other questions as come naturally 
within the scope of the subject and the plan 
of the book. 

Throughout, I have tried to emphasize 
the supreme importance of common sense 
and simplicity. We live in an age of so 
much unrest and facile distraction, that it 
is essential for the mothers of the race, at 



PREFACE vii 

least, to get back — not to stagnation, for 
I believe with all my heart in progress — 
but to the knowledge and the practice of the 
ways of nature in those things which most 
intimately concern nature. And so I have 
urged, that ^he Ideal should be the Normal — ■ 
as it is in the true meaning of the words, and 
as it must be if the true meaning of life is 
to be understood and translated into health 
and happiness. 

The mere words, " The Mother and the 
Child," have a beautiful significance to all 
normal men and women. They are inter- 
woven with the dreams of religion and the 
idylls of humanity. They have an irresist- 
ible appeal for all who wish to lead rational 
and happy lives and to find in marriage and 
parenthood the sustaining force and real 
fulfilment of the years of maturity. It is 
a blank existence that cannot be lived out 
step by step with all the associations and 
intimate companionship of life-comrade and 
little ones. And so I send out my book to 
those who have taken or are taking the great 
venture, that they may learn so far as I 
can teach them to deal wisely with the big 
and little problems that will come to them; 



viii PREFACE 

to take the right step at the right time; to 
ensure health, so far as it can be ensured, 
and avoid unhappiness. 

And in conclusion : this is a book for men, 
as well as for women. For the mother and 
the child are a man's care, as they are his 
reward and inspiration. 

N. B. 



CONTENTS 

PAGE 

Preface v 

I Care of a Mother during Pregnancy 3 

II The Birth of the Child 17 

III The Nurse 25 

IV The Nursery 34 

V The Feeding of the Child .... 45 

VI Feeding in Disease 65 

VII The Important Infectious and Con- 
tagious Diseases of Childhood . 75 
VIII Nervous Diseases of Childhood . . 102 
IX Minor Disorders of Childhood . . 117 

X Some Simple Operations 134 

XI Eugenics 144 

XII Medical Inspection of School Chil- 
dren 161 

XIII Common Sense 171 

Appendix 179 

Index 187 



THE MOTHER AND THE CHILD 



The Mother and the Child 



CARE OF A MOTHER DURING PREGNANCY 

IT seems to be the universal opinion among 
married women that their life and habits 
during the first few years of married 
life, and especially during the period of 
utero-gestation, should be totally different 
from their life and habits before marriage. 
This is an erroneous idea — an idea which 
has been instilled into the mind of the young 
wife strongly enough, ordinarily, to change 
entirely her mode of living, and in many 
cases strongly enough to affect her physical 
welfare during her pregnancy period. 

While pregnancy does change the physi- 
cal aspect of the system, it does not call for 
any material change, at least for several 
months, in the life the expectant mother 
should lead. Usually, as soon as pregnancy 
is well established, she begins to " take care 
of herself " and to fill her mind with all sorts 



4 MOTHER AND CHILD 

of superstitions and fancies, which, to say 
the least, are detrimental both to her physi- 
cal and mental welfare. False traditions, 
unskilled nurses and incompetent physicians 
have combined to bring about a very dan- 
gerous and deplorable condition. ' 

The first necessity, here as in all other 
perplexities, is common sense. Unless there 
be strong reason, such as, possibly, some 
disease, the matter of pregnancy itself 
should be given as little consideration as 
possible. The most important factor, under 
all usual conditions, is the mental state of 
the patient, and every effort should be made 
to keep her absolutely normal. Obviously, 
she must avoid worry or excitement. This 
may seem like a counsel of perfection, diffi- 
cult to carry into effect. In reality, it is 
as easy as it is essential. The habit of being 
normal can be cultivated with much less 
difficulty and far more satisfaction than 
the habit of nervousness, or despondency, or 
foolishness generally. It should be remem- 
bered that pregnancy and motherhood are 
perfectly normal events, arranged for with 
the utmost care by nature. So long as no 
abnormal conditions are allowed to interfere 



DURING PREGNANCY 5 

with normal and natural developments, the 
results may be looked forward to with com- 
plete confidence. 

Normality, then, is the first requisite. 
The wife should be for all practical pur- 
poses totally unconscious of her condition. 
No reference whatever should be made to 
it by her family. Such questions as " How 
do you feel to-day, dear? " are distinctly 
disturbing to her, mentally, since they con- 
vey a suggestion of the possibility of some 
obscure change in her physical condition, 
and immediately an answer to the question 
may indicate that she feels a little queer 
here and there. Such an answer would in- 
sinuate that there is a physical change, how- 
ever vague, whereas there is in reality noth- 
ing different except a slight mental coloring 
of conditions. 

Early physical changes which take place 
up to the fourth month should give the 
normal patient no inconvenience whatever, 
and most of her previous daily customs 
should be continued as if no impregnation 
had occurred. There is no reason why a 
mental change should take place because of 
these early physical changes — other than a 



6 MOTHER AND CHILD 

change to clearer and firmer normality. 
The condition of the expectant mother's 
mind during the early months of gestation 
plays a A^ery important part in the mental 
development of the child. A onorbid or 
unnatural state of mind on the part of the 
patient has a decidedly bad effect on the 
offspring. Quietness, confidence and men- 
tal self-mastery, on the other hand, will in- 
evitably find their effects in the child's 
disposition. Sunshine and cheerfulness for 
a few months for the mother will mean sun- 
shine and cheerfulness for many years for 
the child. 

As soon as the certainty of pregnancy has 
been established, the proper procedure is to 
consult the family physician and be guided 
by his sound professional advice. But the 
patient must not regard herself as an invalid 
in need of constant care and doctoring. If 
she allows herself to do this, a condition of 
neurasthenia will probably supervene, by 
degrees, so that, before she is aware of it, 
a changed mentality will prevail to such an 
extent that happiness and health will be 
impossible during the pregnancy period. 

Assuming that the patient can throw off 



DURING PREGNANCY 7 

all worry and morbid imaginings, which 
every sensible woman can do easily if she 
cares to try, the question arises as to just 
what she should do to keep in normal phy- 
sical condition. 

Naturally, the first important factor is 
the care of the body. Daily bathing, 
whether the patient has been accustomed to 
it or not, must be a part of the regular 
hygienic routine. For the first six months 
a daily total immersion in tepid water, fol- 
lowed by brisk rubbing, is advisable. After 
this period, warm sitz baths should be taken 
nightly. The parts should receive special 
care and should be washed each day with 
warm water and soap. When swimming 
is part of the regular exercise during early 
pregnancy, bathing for that day is un- 
necessary, except as applied to the care of 
the genitals. The family physician, pro- 
vided he be up-to-date, will be of great assist- 
ance at this time, and it is essential that 
he should take care of the case, though it 
is not necessary that he should be seen fre- 
quently by the patient. 

The one great duty of the physician is 
to watch his patient. This does not mean 



8 MOTHER AND CHILD 

that he should see her personally every little 
while for the first few months ; but he should 
keep informed of her physical and ana- 
tomical condition through a frequent exam- 
ination of the urine, a specimen of which 
should be sent to his office at least every 
month, and toward the latter part of gesta- 
tion every two weeks. It is by this fre- 
q^uent examination of the urine that the 
physician is enabled to determine more ac- 
curately certain important conditions. 

During the first few weeks of pregnancy, 
many women are troubled by gastric dis- 
turbances in the early morning. This 
" morning nausea " or " sickness " is de- 
cidedly unpleasant, but while it is a conmion 
symptom of the condition, it is hardly ever 
serious. The patient should try to realize 
this fact, and to reason with herself that 
it is probably only temporary. I have seen 
many cases where by firm determination the 
symptom has been controlled and even 
stopped altogether. If, however, the pa- 
tient's mental force is not sufficient to help 
her at this time, a change of surroundings, 
diet, or slight exercise will invariably be 
beneficial. It sometimes happens, in spite 



DURING PREGNANCY 9 

of precautions, that the nausea becomes 
more pronounced and vomiting occurs, in- 
creasing to such a degree as to become 
intolerable. In such cases the family phy- 
sician should be consulted without delay. 

Daily exercise is without question advis- 
able, and the fact that the patient is physi- 
cally different has no bearing upon the 
case, at least for several months. There is 
one form of exercise, however, which should 
be abolished during pregnancy, and that is 
automobihng. It is true that the expectant 
mother requires fresh air and change of 
surroundings; but she is not obliged to 
obtain them by means of an automobile. 
Quite frequently I have seen miscarriages 
as the direct result of automobiling. The 
sudden shocks, which it is impossible to 
control, are distinctly bad for the pregnant 
uterus, and though many women can with- 
stand such violence, others are apt to mis- 
carry. I have operated upon a number of 
women whose uterine ligaments were re- 
laxed, in consequence, I am sure, of the 
various abrupt shocks they had received 
while automobiling. It should therefore be 
the duty of the family physician to warn 



10 MOTHER AND CHILD 

patients against this alluring recreation. 
Automobiling must be entirely eliminated 
after pregnancy is well established. 

Tennis, swimming and gymnasium exer- 
cises are excellent when not indulged in too 
violently, and should be continued as long 
as is compatible with comfort. Simple 
walking is one of the finest exercises for 
women in this condition. Croquet can be 
cordially recommended — a game in which 
walking is necessary and in which one's 
attention is — or should be — kept con- 
stantly on the alert. Possibly the most per- 
fect exercise — one which embodies every 
requirement and calls into play every 
faculty — is golf. An ideal exercise as well 
as an ideal game, it can be played up to 
a month or so before confinement. I insist 
upon my patients playing, regardless of 
their condition or appearance, for the game 
is indulged in by people of refinement 
and culture, who would not be likely to 
cause embarrassment to the self-conscious 
patient. 

During the last month of gestation daily 
exercise should be taken just the same, but 
always near home ; and toward the last week 



DURING PREGNANCY 11 

it is advisable that the patient remain around 
the house or grounds. 

Exercise, however, becomes impossible 
at times on account of some abnormality 
or sickness. In such cases I advise daily- 
massage — alcohol rubs. Such a course of 
treatment has a tendency to keep the mus- 
cular system firm and toned up, and is 
beneficial in a general way. 

Two or three months before the arrival 
of the little one, the breasts should have 
special attention. Many young women 
have undeveloped nipples which prove a 
great handicap to the child when nursing 
commences. Gentle massage of the breasts 
is advisable, and it should be done daily. 
The nipples should be pulled gently by the 
forefinger and thumb; manipulated gradu- 
ally and rolled between them so that in time 
an assured development may result, and 
the child have something on which to hold 
when being nursed. After thorough manipu- 
lation the breasts and nipples should be 
washed, and the nipples rubbed with alcohol 
or eau de Cologne, followed by a treatment 
with a little cocoa butter. Inverted nipples 
are unfortunate, and every expectant 



12 MOTHER AND CHILD 

mother should give attention to the develop- 
ment of this important point, for it is most 
desirable that she should nurse her own 
child. Women who patiently and per- 
sistently practise gentle massaging of the 
breasts seldom suffer from what is known 
as " caked breasts " ; they are practically 
sure of an abundance of milk, which repays 
them for all the care they bestowed upon 
themselves. 

The question of sexual intercourse is of 
extreme importance. An " undisturbed 
maturity " is undoubtedly ideal, but, un- 
fortunately, it is rarer than it should be. 
Intercourse may be regularly — if carefully 
— practised ; but it should certainly be re- 
stricted as much as possible. During the 
times the monthly periods would have oc- 
curred it must be prohibited, since at these 
times the patient is most hkely to miscarry. 
During the last two months of pregnancy, 
intercourse should cease altogether; and the 
passages should be kept scrupulously clean. 

Douching is unnecessary, but toward the 
end of gestation a warm-water douche, 
about two quarts containing a tablespoon- 
ful of boracic acid dissolved in it, is bene- 



DURING PREGNANCY 13 

ficial. Before using the douche, the glass 
nozzle should be thoroughly boiled to ster- 
ilize it, and great care must be used when 
inserting it. 

A few simple rules are advisable with 
regard to clothing: 

1. Clothing should always be comfort- 

able. 

2. After the fourth month corsets should 

not be worn. 

3. Avoid all constriction or pressure, es- 

pecially upon the enlarging breasts. 

4. During the last few months a strong 

linen binder should be worn as an 
abdominal support. This will be 
found to be of great comfort. 

The appropriate dress ought to conform 
with the patient's own ideas and taste, 
guided by the above brief rules. 

While I have mentioned exercise as en- 
tirely beneficial, it must not be forgotten 
that rest is equally beneficial and necessary. 
There is a time for each if one has learnt 
to live on twenty-four hours a day, as Mr. 
Arnold Bennett puts it. A good night's 
rest is always essential, and a mid-day rest 



14 MOTHER AND CHILD 

will be indulged in with great comfort dur- 
ing the latter period of pregnancy, when 
the uterus becomes heavy. Mental and 
muscular relaxation are invaluable during 
the middle of the day, so that the tired ner- 
vous system may refresh itself. 

The daily movement of the bowels is of 
the utmost importance, and should the ex- 
pectant mother have trouble with regard to 
this function her physician must be consul- 
ted at once. Constipation during preg- 
nancy is bad, as it is invariably associated 
with a great amount of straining, which 
should always be avoided. Unless the 
bowels are regular, with a satisfactory daily 
movement, attention should be given not 
only to exercise but also to food-stuffs, as 
a more liquid diet, cereals or fruit, may be 
necessary, and with reference to this the 
family physician should be consulted. Tak- 
ing medicine is a bad practice, the various 
laxatives and cathartics quite frequently 
doing more harm than good. An excellent 
rule to follow while in this condition is never 
to take a dose of medicine unless it is pre- 
scribed by a physician. The bowels can and 
should be regulated by other means. 



DURING PREGNANCY 15 

Before closing this chapter I wish to im- 
press strongly upon the minds of my readers 
the importance of consulting the family 
physician at any time when the peculiar 
symptoms of pregnancy suggest to the pa- 
tient something unusual. If nothing im- 
portant is the matter, the physician will 
relieve her mind and prevent her from 
worrying over a mere trifle. On the other 
hand, if anything really requires attention, 
it is far better to secure that attention at 
once, and avoid the possible consequences 
of delay. A physician should be consulted 
when the patient is troubled by any of the 
following symptoms: 

1. Heartburn. 

2 . B ackache ( extreme ) . 

3. Pain in the abdomen (intermittent). 

4. Flatulence. 

5. Sharp lancinating pain on either side 

of the abdomen during the first four 
months. 

6. Constant headache or dizziness. 

7. Excessive discharge. 

8. Bleeding. 

9. Pain upon urination. 



16 MOTHER AND CHILD 

10. Itching of the genitals. 

11. Neuralgia. 

12. Hemorrhoids. 

Although pregnancy is a perfectly natu- 
ral physiological condition, we must not lose 
sight of the fact that there are certain women 
whose physiological, nervous or anatomical 
condition is so distorted or changed that the 
state of pregnancy means to them a state 
of ill health. It becomes necessary for the 
physician to exercise the most diligent care 
in handling such cases, and he should be 
called upon for counsel whenever occasion 
arises. The experience of an up-to-date 
physician is necessarily of great value to a 
patient, and the advice he is able to give in 
serious cases should never be regarded 
slightingly. 

" The mother will be well advised, if at 
any time during her pregnancy she feels 
unwell or anxious about herself, to seek the 
advice of the doctor rather than of friends, 
who, with the best intentions, often do more 
harm than good at this time." ^ 

^ " Practical Motherhood/' by Helen Y. Campbell, 
L.R.C.P. and S., Edin. 



II 

THE BIRTH OF THE CHILD 

BEFORE going into the essentials of 
the birth of the child, I think it is 
advisable to give Doctor Ely's table 
and Naegele's Rule, showing the possible 
date when confinement may be expected. 

Explanation: The top line gives the 
dates of the last menstruation. The figures 
below show the date when confinement may 
be expected. In leap year the birth may 
be expected one day earlier. 

Naegele's Rule is also simple and is 
figured out in the following way : There are 
as a rule 280 days between the last men- 
strual period and confinement. Count back 
three months from the first day of the last 
menstrual period and then add seven days: 
e. g., if the first of the last menstrual date 
was April 1, counting back three months 
would make it January 1, adding seven days 
would make confinement probably fall on 
January 8. 



18 MOTHER AND CHILD 



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BIRTH OF THE CHILD 19 

These rules are fairly accurate and con- 
finement will take place within a day or so' 
as a general rule. A woman having her 
first baby cannot always count upon the 
exact day — quite frequently first babies 
are a little late or early, as the case may be. 

During the nine months of pregnancy 
and prior to the end of utero-gestation there 
are certain curious phenomena which the 
mother invariably notices indicative of in- 
teresting foetal development. 

First Month: Menstruation almost in- 
variably ceases — although it may not, 
which, however, is very unusual. 

Second Month: The uterus increases in 
size; gastric disturbances begin; slight 
changes in the breasts. 

Third Month: The uterus increases in 
size; the breasts become darker around the 
nipples; depressed umbilicus is the rule; 
occasionally at the end of the third or the 
beginning of the fourth month the bladder 
becomes irritable and urination frequent. 

Fourth Month: Stomach or gastric irri- 
tabihty lessens; bladder irritability is gen- 
erally more pronounced; the uterus grows 
more rapidly, enlarging abdomen; move- 



20 MOTHER AND CHILD 

merits of foetus are distinguishable. 
" Quickening " occurs ; viz., the foetal move- 
ments are transmitted through the uterus 
to the abdominal wall. 

Fifth Month: The uterus is increased in 
size and movements of the foetus are much 
more active. 

Sixth Month: Previous symptoms con- 
tinue. The physician can generally hear 
the heart sounds. Enlargement of the 
uterus to the navel. 

Seventh Month: Breasts much darker. 
" Colostrum " may be squeezed out of 
nipple. Longitudinal lines like small cracks 
in the skin appear on the abdomen from the 
pubes to the navel. 

Eighth Month: The abdomen is now quite 
large and the navel very prominent. 

Ninth Month: Breathing is generally im- 
paired, due to the pressure of the greatly 
distended uterus. Swelling of the vaginal 
parts is noticed; the bladder condition is 
very annoying; the rectum protrudes and 
hemorrhoids are common. Swelling of the 
legs is noticed and walking becomes difficult 
and tiresome. "Lightening" occurs; viz., 
the dropping of the uterus into the pelvic 



BIRTH OF THE CHILD 21 

cavity. This generally happens about a 
week or so before confinement and greatly 
relieves the gastric symptoms and labored 
breathing, which have been annoying for so 
long a time. 

Peepaeation of the Bed 

The bed should not be too high and the 
springs should be fairly hard. A firm, 
comfortable, smooth hair or spring mattress, 
giving firm support, is much better than a 
feather bed. I prefer an individual, white 
enamel bed, or brass bed, which should be 
placed about in the middle of the room, so 
that it is easily accessible from all sides. 
Such a bed when soiled can be readily 
cleansed and changed with more ease. 

The permanent dressing is the first con- 
sideration : Place over the mattress a rubber 
sheet, and over this a sterile sheet; both 
sheets should be firmly pinned to the four 
corners of the mattress. Place another 
rubber sheet on top of the permanent bed 
and then a rather thick pad of some soft 
material, over which is placed another sterile 
sheet. This top dressing is entirely tern- 



22 MOTHER AND CHILD 

porary, for it is invariably soiled and must 
be removed after confinement. 

The following symptoms of impending 
confinement are valuable to note : As I have 
said, about two weeks before labor the 
uterus falls into the pelvis and the abdomen 
becomes flatter. The waist line changes and 
breathing is easier. About the time labor 
is expected, the patient's general condition 
is changed. The anxiety of the patient is 
profound. The general appearance of fear 
is common and extreme restlessness is no- 
ticeable. Patients invariably want to lie or 
sit down and will only remain in one posi- 
tion for a short period of time. Irritability 
of temper is common and unavoidable. The 
entire temperament changes and the pa- 
tient is likely to be quite critical and cross. 
Fretfulness is also marked and even little 
things are disagreeable and annoying and 
irritate her greatly. The first pain gener- 
ally appears about this time and is due to 
uterine muscular contractions. This pain 
occurs at regular intervals and becomes 
more frequent and severe. These pains are 
felt at the lower part of the back as a gen- 
eral thing and extend to the front of the 



BIRTH OF THE CHILD 23 

abdomen and quite often down the thighs. 
The pains are more aching in character at 
first, but as they develop become colicky and 
cramp -like, lasting from ten seconds to one 
minute or more. During the attacks pa- 
tients are more nervous and irritable and 
frequently desire to urinate and defecate. 
Moving the bowels and emptying the 
bladder are necessary and should be atten- 
ded to whenever possible. Between pains 
patients are extremely anxious, and after- 
wards invariably relax into a nonchalant 
state of tiredness. 

A bloody mucous discharge from the 
vagina appears, known as the show. The 
show appears generally about the time the 
first few indefinite pains occur or shortly 
afterwards. It is due to the stretching of 
the uterus and the tearing of the fine uterine 
tissues which bleed very readily. 

Labor is now about to commence and the 
patient should prepare herself for delivery. 
If the doctor is at hand, it is advisable for 
her to assist labor all she can by following 
his advice. If, however, the doctor is not 
present, the patient should lie down and 
remain as quietly as possible until medical 



M MOTHER AND CHILD 

assistance arrives, as this will retard her 
progress as a rule. Patients can assist or 
retard labor as they please to a certain de- 
gree, and when the physician is in the house 
it is to her advantage to assist her progress 
all she can in order to shorten confinement. 



Ill 

THE NURSE 

THE question of a nurse for the child 
is most important; but it does not 
need much discussion. There is but 
one kind of nurse that is at all satisfactory, 
and that is the graduated trained nurse; 
and even she, at times, is not precisely 
perfect. 

" If the child is to have a nurse," writes 
Helen Y. Campbell,^ " her choice is a very 
important consideration. Wherever possi- 
ble, it is an undoubted advantage to have 
some one who can attend efficiently to the 
little practical duties of bathing and dress- 
ing, washing of napkins, feeding and airing. 
It is, however, of such supreme importance 
that the person undertaking these duties 
should be entirely suitable, thoroughly effi- 
cient and trustworthy, that if she cannot ful- 
fil these conditions the mother would be em- 

^ " Practical Motherhood," pages 53 and 54. 



26 ^ MOTHER AND CHILD 

phatically the best nurse for the child; and 
even where she does, the mother's supervision 
must be close and unwearying." 

The so-called " nurse girls " who have had 
but a few months' training in some baby 
hospital are, as a matter of fact, worthless 
as nurses. They invariably lack most of the 
primary essentials for nurse equipment, and 
their knowledge of children is so primitive 
that it seems ludicrous even to call them 
nurses. But they are so styled, and there 
are many mothers who allow them to mas- 
querade under the title of nurse and assume 
all the duties and dignity of a graduate 
nurse. Yet these girls are rarely more than 
servants, with a smattering knowledge of 
the principles of the nursery and nursing, 
and an inflated idea of their own impor- 
tance. Physicians of standing and intelli- 
gence should not permit their patients to 
employ such girls; yet the comedy goes on, 
and generally much to the detriment of the 
poor infant. 

These girls are not merely useless for the 
ordinary purposes of nursing, and worse 
than useless in emergencies : they are a posi- 
tive danger, and that is why I consider it 



THE NURSE 27 

necessary to issue a strong and unmistak- 
able warning. Their embryonic knowledge, 
for instance, of the action of castor oil gives ^ 
a clue to the entire story of incompetence. 
They have heard physicians order a dose of 
castor oil for various complaints, and they 
know that if enough be given the bowels of 
the infant move — which is sufficient so far 
as they are concerned. The action of the 
drug outside its cathartic properties, or the 
therapeutics of it, is as foreign to them as 
the topography of Tibet. So it is with al- 
most everything else they practise. Their 
ideas of asepsis are pitiful, and I have yet 
to find one who understands even the rudi- 
ments of sterilization. Frequently I have 
observed nurses of this type boil a rubber 
nipple, take it out of the water with dirty 
fingers, pull it over the neck of the milk 
bottle, and immediately put it into their own 
mouth to see if the milk ran freely and that 
it was not too hot. (Imagine a nurse with 
incipient tuberculosis or syphilis carrying on 
such a procedure!) Incompetent help of 
this kind should never be employed; they 
are not nurses, though they constitute a great 
menace to the nursing profession. I could 



28 MOTHER AND CHILD 

give many instances of both dangerous and 
disgusting results, due to their ignorance 
and carelessness ; but I am sure, after what 
has already been said, that no patient who 
reads this book will disregard the warning 
I have given. 

One of the first principles a nurse should 
learn is never to prescribe for a patient. A 
nurse is not a physician, and her duties 
should never infringe on those of the medi- 
cal man. However, these so-called nurse 
girls, or " castor oil nurses," do just what 
they should never do, namely, prescribe. 
Almost the first rudimentary information 
they acquire regarding their supposed duties 
is how to give castor oil or calomel, and 
to insert a suppository; and immediately 
upon securing a position they commence 
their stupid practices upon the children 
they are paid to care for, invariably at 
the expense of the health of these Httle 
ones. 

It is, of course, impossible for many fami- 
lies to afford the services of a trained pro- 
fessional nurse, and to those who cannot I 
wish to emphasize the fact that it is far 
better to have no nurse at all, unless it be 



THE NURSE 29 

possible to engage a trained and cultured 
one. The mother who is capable of giving 
birth to a child is usually capable of taking 
care of it, and should rightly do so in pref- 
erence to running any risk of incompetence 
and carelessness. The frail little bit of hu- 
manity ought never to be left to the care 
of any one else, unless it be to that of an 
able, well-educated woman who not only 
understands her professional duties, but 
who has also some refinement and sound 
judgment. 

The employed nurse should have a fair 
education outside of her professional train- 
ing. Refinement is an essential quality. 
She should come well recommended either 
by her training-school superintendent or by 
the physician who is instrumental in select- 
ing her for the family. She should be true 
to her trust, willing to work, kindly and 
adaptable. A nervous, irritable woman is 
invariably a bad nurse. 

Loyalty to the child and to the family she 
is working for is an important characteris- 
tic of a good nurse. She should also never 
be overbearing or peremptory in her man- 
ner. She must be considerate and reason- 



30 MOTHER AND CHILD 

able, so that when affairs do not run 
smoothly enough to suit her, she may be 
able to explain quietly and offer to correct 
the various difficulties. 

There is a strong prejudice to-day among 
the laity regarding the trained nurse, and 
it will take time to overcome that prejudice. 
There is more than sufficient excuse for it. 
Too many trained nurses are, unfortu- 
nately, egotistic enough to think that when 
they have charge of a case, their position 
confers upon them absolute authority, with 
the right to ignore the family entirely. 
They have a regrettable habit of going into 
homes and immediately making themselves 
a profound nuisance rather than an aid. 
Large numbers of professional people, and 
especially of trained nurses, are unable to 
grasp the fact that the laity have not re- 
ceived a technical education and should not 
be stupidly criticised or slighted when ask- 
ing technical questions regarding the care 
of the sick or of sickness. The indifference 
and superior air which some nurses seem 
to possess with respect to everybody in the 
household, except, perhaps, the patient, have 
been, I believe, the main factors in arous- 



THE NURSE 31 

ing in the minds of the laity this strong 
feeling of prejudice. 

The scope of the nurse's duties is so 
varied and extensive that every moment of 
her time will probably be taken up. If, 
however, she has any spare time, she should 
carefully expound to the mother the essen- 
tials of scientific care of the infant. She 
should also explain gradually, in an agree- 
able conversational manner, the general rules 
of health, hygiene and the care of the sick, 
avoiding any attitude of superiority or self- 
importance. 

On the other hand, the laity should re- 
member that a trained nurse, like a trained 
physician, has spent several years in hard 
work, learning her profession. Her duties 
are certainly not simple, and the numerous 
little technicalities which are learned within 
the four walls of a hospital represent ex- 
perience of great value. The mother who 
considers herself better able to direct the 
care of her baby than a competent, scien- 
tifically trained nurse is distinctly mistaken, 
and a realization of this fact will prove 
extremely beneficial both to herself and her 
child. 



32 MOTHER AND CHILD 

A happy disposition of content should 
be established at once between mother and 
nurse, and from the moment the nurse en- 
ters the house it should be her duty to instil 
a feeling of confidence, relief and pleasure. 
On the other hand, the family should make 
the nurse feel at home and comfortable, 
should show her thoughtful consideration, 
and try to appreciate that she is a messen- 
ger of hope, doing all that she can, accord- 
ing to the laws of science and for the benefit 
of those for whom she is working. If such 
an instinctive, agreeable feeling of friend- 
ship exist between employee and employer, 
the result will be immeasurably better than 
if there exist a feeling of doubt or discontent. 

One of my best patients once said to me : 
" Doctor, I don't like that nurse." 

"Why?" I asked. 

" Oh, I don't know," was the answer. " I 
suppose it 's her face." 

"What's the matter with her face?" I 
continued. 

" Oh, nothing, I suppose. But I just 
don't like it." 

This nurse had a sweet, comely face, in- 
dicative of character. After the baby came 



THE NURSE 33 

and the nurse began to show her real abihty, 
I asked whether I • should discharge her. 
The mother's answer was typical. 

" No, Doctor; she is so sweet and kind 
and lovely to the baby. I simply would n't 
have anybody else." 

Briefly, the nurse should be between 27 
and 37 years of age, and a graduate with 
experience sufficient for any duty pertain- 
ing to the care of a child in sickness or in 
health. She should have good teeth and 
good digestion. Her habits should be ex- 
emplary; her attire at all times scrupu- 
lously clean. Her person, and especially 
her hair, should be washed frequently, and 
her finger-nails manicured. Her work 
should be her dominating thought when on 
duty. She should be amiable, amenable to 
reason and with sound judgment and skill. 
If such a nurse can be secured, the mother 
can rest assured that her child will have 
true care and devotion and that its physical 
start in life will be attended by every favor- 
able condition for an entirely satisfactory 
result. 



IV 

THE NURSERY 

IT is essential that the best and most de- 
sirable part of the entire house be turned 
into the nursery. A single room is all 
that is absolutely necessary, but a suite is 
far preferable if the family can afford it 
and the space can be spared. 

If only a single room is to be used, the 
first consideration is the size. A cramped, 
stuffy bedroom or ballroom should never be 
utilized for a nursery, nor one that has not 
plenty of light. Light, warmth and fresh 
air are most important factors in raising a 
young child, and a room selected with these 
cardinal requirements in mind should be all 
that is desirable. 

The room chosen ought to be sufficiently 
large to contain comfortably a bed for the 
nurse and a crib for the child. No un- 
necessary decorations should be allowed; 
only simple gauze or some washable cur- 
tains should hang over the windows; the 



THE NURSERY 35 

floor should be hard poHshed, with two small 
washable rugs upon it. Dark shades for 
all the windows are necessary. The walls 
should be tinted a pearl gray — I do not 
approve of the glaring white walls so com- 
monly used in hospitals and baby homes, 
nor do I approve of wall papers, for they 
are dirty and unhealthful, and cannot be 
cleansed as can painted walls. A soft pearl- 
gray painted wall is the most pleasant, and 
grows still more agreeable, while a white 
wall is cold in appearance and becomes more 
and more disagreeable. Picture mouldings 
should be taken down. In the first place, 
they are unnecessary; and in the second 
place, they are almost invariably put into 
use, which is contrary to all true ideas of 
hygiene and definitely invites disease. I 
have seen nursery walls covered with pic- 
tures that had not been dusted for months 
— showing, of course, that there had been 
disgraceful neglect on the part of some one. 
Picture mouldings and pictures, then, should 
be banished from the nursery. 

With regard to the furniture, there are 
two elementary rules : simplicity and utility. 
Nothing should be in the room that is not 



36 MOTHER AND CHILD 

indispensable. The beds should be of brass 
or white enamelled metal — wooden beds 
must not be used. The baby's crib should 
be fairly large, with two high sides which 
unfold or let down. These are undoubtedly 
the most practical kind and should be in 
universal use. 

A white or gray enamelled bureau, with a 
glass attached, is necessary to contain the 
child's clothing and sundry toilet articles. 

There should be three chairs — one rocker 
and two straight backs — all cane-bottomed. 

A metal, white enamelled table, about 
twenty-four inches by thirty-six, should be 
kept in the nursery, and a smaller one in 
the bathroom ; the smaller table should have 
three glass shelves. 

A pair of baby scales should be kept on 
the bureau, and also a chart board with a 
chart showing the child's record complete 
in every detail. 

Attached to the main nursery bedroom 
should be an anteroom, if possible, for extra 
bedding, baby linen and sundries. The 
bathroom should be connected or easily ac- 
cessible. The hygiene of the bathroom is 
of the utmost importance. Scrupulous 



THE NURSERY 37 

cleanliness is essential. An ideal bathroom 
should have tiled sides and floor, painted 
walls, a porcelain tub and a porcelain wash 
basin. A small folding rubber tub is very 
convenient for the use of infants. A plain, 
small, washable rug should be kept on the 
floor, and there should be a metal or small 
wooden towel rack. 

Each room should be equipped with a 
temperature thermometer, and the bath- 
room should have a bath-tub thermometer. 

The temperature of the nursery is at all 
times decidedly important. During the 
wakeful periods the range of heat should 
be between 69 and 71 degrees Fahrenheit. 
The anteroom ought to be kept at an even 
temperature at all times and should never 
be allowed to grow cold. Clothing should 
be kept dry, and if there is a continued 
change of temperature and atmospheric 
conditions in the anteroom the clothing is 
apt to become damp. 

The bathroom must be kept quite warm 
during the process of bathing the infant. 
Under no circumstances should the win- 
dows of the bathroom be open during this 
time. 



38 MOTHER AND CHILD 

Airing the rooms, however, is of course 
as necessary as heating them. This venti- 
lation should be carried out thrice daily 
for a period of some minutes, the child 
meanwhile being covered with an extra 
wrap, or else taken out temporarily into 
another warm room. 

During sleeping hours the nursery should 
be closed completely from the anteroom or 
the rest of the apartment, and the windows 
should be opened so that the child may 
sleep in fresh air. Care must be taken, 
however, that the child is never in a draught 
while sleeping, and to accomplish this the 
sides and ends of the bed should be cov- 
ered with blankets or sheets. 

Heating the nursery by means of the 
open fire is the best method; steam heat 
and the hot-air furnace are distinctly bad. 
Gas stoves must not be used under any 
consideration. 

With reference to the nursery. Dr. Ker- 
ley, in " Short Talks with Young Mothers " 
(page 11), makes the following excellent 
remarks : 

" Steam heat as ordinarily used to-day 
is the least desirable means of heating on 



THE NURSERY 39 

account of its uncertainty. In many New 
York apartments of the better class the 
fires are banked at 10 p. m. The tempera- 
ture when the child retires is from 70 to 
80 degrees F. or more; by five or six 
o'clock in the morning a fall of from 50 
to 60 degrees F. has taken place. Such a 
change in the temperature, with the ten- 
dency of children to kick off bedclothes, 
explains many cases of tonsilitis and bron- 
chitis. The temperature of the nursery 
should be kept as even as possible. When 
for any reason this cannot be controlled, 
it is best to have two means of heating, so 
that when one fails the other can be used. 
The open-grate fire or small wood stove is 
best." 

After the child becomes older, and if there 
are then no babies in the family, the follow- 
ing changes are advisable, as they would 
certainly do no harm to an older child and 
the room becomes much more pleasing both 
to the child and to others. Of course, for 
an infant which spends three-quarters of its 
time in the nursery, every precaution must 
be taken to avoid unnecessary risks. But 
as the child grows older it becomes less 



40 MOTHER AND CHILD 

susceptible to the ailments of babyhood and 
is more likely to throw off sickness. 

Toys of various kinds, then, could be 
brought into the nursery during play times ; 
also books. The room can be brightened 
with one or two ornaments, such as a vase 
on the mantelpiece. A few attractive pic- 
tures can now be hung, but upon no con- 
sideration should picture moulding be used. 
The old-fashioned nail is the better method. 

Speaking of ornaments and pictures, 
Mrs. H. C. Craddock, in her able book on 
"The Training of Children," says: 

" Children are unconsciously influenced by 
their surroundings, and if we want them 
to love and admire beautiful things we must 
see that their taste is not spoilt in their 
more impressionable years by letting their 
eyes become familiar with things that are 
ugly or vulgar. Our aim must be to 
make the nurseries cheerful, orderly and 
beautiful." 

For young babies, however, we do not 
need any adornment in the nursery; on the 
contrary, a complete lack of it must be in- 
sisted upon. But when children grow older 
and learn to appreciate stories and reading. 



THE NURSERY 41 

the nursery is a fit place for a few beauti- 
ful books. The importance of child litera- 
ture can scarcely be overestimated. My- 
riads of books have been written, but there 
are really only a few which are entirely 
satisfactory for the child to read and be- 
come familiar with. The following are the 
essential conditions that should be embodied 
in the literature chosen for the child: 

1. Books should be chosen with great care 

and only those with the charm of 
well-written English should be per- 
mitted in the nursery. From baby- 
hood the child's literature should 
be in simple, correct and beautiful 
language, which he will instinctively 
absorb into his own vocabulary and 
by means of which he will acquire 
much in the way of accurate speech 
and clear, correct thinking. 

2. Before a book is read to a child or 

given to him to read by himself, it 
should first be read by the parent 
to determine its fitness. 

3. Well-written animal books are suit- 

able. 



42 MOTHER AND CHILD 

4. Story books containing ugly ideas or 

tragedies are distinctly unsuitable. 

5. Allegorical stories are much appreci- 

ated by some children. 

6. Well-written books with a true, simple 

sense of humor are excellent; but 
the so-called " comic books " should 
never be permitted in the nursery. 
False humor is as bad as false 
morality; and it is unwise, to say 
the least, to cultivate a spirit of mere 
frivolity in a child. 

7. Books upon nature studies are admir- 

able. 

8. Stories with " morals," with virtue 

triumphing over wrongdoing, are 
permissible, and, when selected with 
care, invaluable. But the moral 
should develop naturally; there 
should be no portentous solemnity 
or heaviness. The child must not 
feel that he is being simply preached 
at. He must absorb the principles 
that build up character as he absorbs 
fresh air and sunshine, naturally, 
willingly, without resentment. The 
books of narrow-minded or preju- 



THE NURSERY 43 

diced authors should be rigidly ex- 
cluded. The largest minds express 
themselves with the greatest sim- 
plicity. The child, consciously or 
sub-consciously, is affected more and 
more deeply as he grows older by 
the spirit that reveals itself in his 
books. That spirit should be gra- 
cious and simple, the spirit of beauty 
and knowledge, of harmony and 
comprehension. 

I have spoken at some length on this 
subject, because I consider it of extreme 
importance. The child is father to the man 
more completely than we have yet realized. 
The self-centred and restricted view-points, 
the hasty and erratic temperaments, the 
unstable characters and undeveloped men- 
tality that we see in many men, can be 
traced in large degree to neglect and im- 
perfect guidance during their childhood 
days. A little care in the early years means 
freedom from care as the years pass on. 
I will add only a few more words: Pic- 
tures are essential to a growing child; the 
visual stimulus is more vivid than the audi- 



44 MOTHER AND CHILD 

tory. He should have, therefore, illustrated 
books ; and the same care should be devoted 
to this feature that is given to the sub- 
ject-matter and general suitability of the 
book. 



THE FEEDING OF THE CHILD 

FROM the moment the child is born 
the question of feeding is of vital im- 
portance, and it is the duty of the 
mother to give her devoted attention to 
raising her little one without the aid of arti- 
ficial means. The mother's milk is, beyond 
all doubt, the best for infants. 

Immediately after the birth of the child 
and for some time subsequently, the mother's 
breast discharges what is known as " colo- 
strum," or the first milk. This colostrum 
should be given to the child; it is of great 
benefit and freg^uently acts as a mild laxa- 
tive for the infant. The baby should be 
put to the breast and nursed as quickly 
after birth as is convenient for the mother 
and child, for promptness in this matter is 
of the utmost importance to both. From 
this time up to the period of weaning, the 
mother must give herself over almost com- 
pletely to her child, and feed it as it should 



46 MOTHER AND CHILD 

be fed. No scientist has yet been able to 
duplicate mother's milk, and it is doubtful 
whether an efficient substitute will ever be 
discovered. Nature knows her own ways, 
and she certainly intended the child to be 
fed by its mother, providing for the specific 
purpose an absolutely perfect food. 

Every mother should nurse her own child 
as long as possible. Even if for any extra- 
ordinary reason she is able to do this for 
only a few months, it is a great gain for 
the child, which thrives better from the be- 
ginning, and can more easily overcome dis- 
ease at a later stage. 

There are very few reasons why, in spe- 
cial cases, mothers should not nurse their 
own children, and I will enumerate them: 

1. Absence of sufficient milk. 

2. Extreme nervous disease and hysteria. 

3. Epilepsy. 

4. Heart disease. 

5. Infectious and contagious diseases. 

6. Imperfect breast or nipple develop- 

ment. 

I know of no other reasons which are 
worth considering, and the mother who en- 



FEEDING THE CHILD 47 

deavors to find excuses for leaving the 
feeding of her child to a nurse is an un- 
worthy mother, and may be responsible for 
completely ruining the health of her child. 
Yet I have known in my own experience 
many mothers whose chief anxiety seemed 
to be to rid themselves of the care and feed- 
ing of their children, and there are far too 
many faddists and even physicians who are 
willing to cater to the whims of the hysteri- 
cal or selfish woman who adopts the idea 
that she will not or cannot nurse her baby. 
The results can only be disastrous, and 
mothers must be brought to realize the 
truth. Artificial feeding may be used in 
emergencies. In all normal conditions it 
must be forbidden, absolutely and univer- 
sally. 

This point is emphasized by Sir John E. 
Gorst, in his book " The Children of the 
Nation": 

" In rearing infants there is no absolutely 
satisfactory substitute for mother's milk. 
The most scientific system of artificial feed- 
ing is but a poor, though in some cases an 
unavoidable, makeshift. Statistics show 
that in the epidemics of children the per- 



48 MOTHER AND CHILD 

centage of deaths among the bottle-fed is 
far greater than among the breast-fed. It 
appears from statistics published in 1905 
by the Medical Officer of Health in Bir- 
mingham that out of 178 infants who died 
under six months old, 16 were fed at the 
breast, 28 were partially fed at the breast, 
and 134 were artificially fed; and the Medi- 
cal Officer gives it as his general experi- 
ence that in the diseases of infants the 
mortality is at least thirty times as great 
amongst those who are brought up by hand 
as amongst those who have been reared on 
their natural food." 

Mother's milk contains essential elements 
— fat, sugar, proteids, salts and water — 
which are better proportioned than in any 
artificial food-stuffs. There are cases when 
it is necessary, for special and unfortunate 
reasons, to adopt artificial feeding ; but only 
after the fullest consideration and upon the 
advice of the family physician should a 
child be allowed to feed upon anything 
other than the breast. 

In her book " Practical Motherhood," 
Helen Y. Campbell says: 

" Breast milk as the baby drinks it is a 



FEEDING THE CHILD 49 

living fluid fashioned by the living cells of 
the mother's breast out of the nourishment 
brought to them by her own blood. It is 
absolutely pure and free from germs. It 
is taken directly into the baby's stomach 
at the temperature at which it leaves the 
breast. Its ingredients are not only spe- 
cially adapted to the needs and the diges- 
tive organs of the young human animal, 
but are designed to educate these gradually 
to perform their functions as the child be- 
comes increasingly stronger." 

As I have stated, the child should be 
nursed immediately after birth. Sometimes, 
however, this is impossible, as the milk is 
delayed for a day or two. In such cases 
the family physician will advise sterile water 
to be given to the infant regularly. Within 
three days nature generally provides an 
abundance of milk. 

Cleaning the nipples and the baby's 
mouth is absolutely essential before nurs- 
ing. The breasts, and especially the nip- 
ples, should be bathed and then washed off 
with a saturated solution of boracic acid 
before every feeding. The child's mouth 
should also be gently washed with a piece 



50 MOTHER AND CHILD 

of fine gauze wrapped around the little 
finger and dipped into a solution of boracic 
acid. The gauze-covered finger should be 
gently inserted into the child's mouth and 
revolved carefully in the buccal cavity. As 
the finger is being withdrawn, be sure to 
wipe slightly around the gums and the inner 
side of the lips. After a very little expe- 
rience, this practice will prove quite simple 
and the child will not object to it; but 
great gentleness must be used, because at 
times, especially during the first teething 
periods, the child's gums are distinctly sore 
and pressure on them is painful. This 
cleansing of the child's mouth and the 
mother's breasts and nipples should never 
be neglected. It is impossible to overes- 
timate the value of a faithful and untiring 
observance of the practice. 

After nursing, the breasts and nipples 
should be carefully examined to see that 
there are no cracks. Quite frequently the 
nipples become cracked, or a fissure forms; 
and whenever this happens immediate care 
must be given to heal them, or nursing will 
become impossible, for the pain would be 
unbearable to the mother. A child should 



FEEDING THE CHILD 51 

never be permitted to nurse on a cracked 
nipple, and when such a condition is pres- 
ent a nipple shield should be used. This 
shield answers every purpose and the child 
invariably takes kindly to it, though a little 
patience may sometimes be necessary at 
first. 

The sore nipple should be gently bathed 
with a solution of boracic acid after each 
nursing and then dried, after which it should 
be covered with a thin layer of zinc oxide 
ointment upon a sterile piece of gauze. Be- 
fore the next feeding the ointment is gently 
but thoroughly washed off. Nursing may 
be resumed after the nipple is completely 
healed and able to withstand rough pulling. 

Should the breast at this time become 
generally troublesome — painful, hard or 
too full — massage, very gently performed, 
should be begun at once, warm olive oil 
being used. This, combined with the relief 
given by the English breast pump, will suf- 
fice. But it is always advisable to consult 
a physician when the breasts become pain- 
ful, as abscesses may sometimes form, which 
yield readily to proper treatment, but are 
aggravated by delay. 



52 MOTHER AND CHILD 

The child should be fed every two hours 
during the day, and only twice during the 
night. Authorities differ with regard to 
the time that should be consumed in feed- 
ing. About fifteen to twenty minutes is the 
most satisfactory average. 

Some children develop the habit of sleep- 
ing on the breast, which delays feeding for 
too long a period. This is a bad practice 
and should be stopped by withdrawing the 
nipple and not allowing food to be taken 
for a short period. The child will then get 
over the habit promptly. The mother should 
take particular pains to alternate the breast, 
making this an invariable rule, provided 
that both nipples are perfect and able to 
be used. 

The natural feeding, as I have so clearly 
insisted, is breast-feeding. Artificial feed- 
ing is unnatural, and at the best a make- 
shift, though circumstances may arise which 
render it inevitable, so that it becomes the 
duty of the parent and the physician to en- 
sure that it is the best makeshift obtain- 
able. The whole subject of artificial feed- 
ing is intricate and difficult. When a child 
cannot be brought up properly upon the 



FEEDING THE CHILD 53 

breast, a specialist should invariably be con- 
sulted, for the selection of the right substi- 
tute cannot be left to the mother. I will 
mention a few of the various substitutes 
and food-stuffs in more or less general use: 

1. Wet Nurse: Upon no consideration 

should any one but a " child's spe- 
cialist " or an able practitioner be 
allowed to select one. 

2. Cow's Milk: Source of supply and 

strength extremely important. 
Cheap milk, of course, is not re- 
liable and should not be used with- 
out investigation. 

3. Sterilization and Pasteurization: Re- 

quires careful study. 

4. Condensed Milk: This should never 

be given to a baby if cow's milk 
can be procured. 

5. Peptonized Milk: A predigested milk 

— an important study. 

6. Proprietary Food: Such as Imperial 

Granum, Malted Milk, Eskav's 
Food. They are used to a great 
extent, but the advice of a physi- 
cian is essential. 



54 MOTHER AND CHILD 

The subject of infant feeding is at the 
best not easy. Each individual child is a 
law unto itself, and it is a difficult task to 
attempt to lay down a set of rules and put 
literature into the hands of those who are 
untrained and unscientific, however intelli- 
gent and conscientious. They cannot ex- 
pect to follow a particular rule undeviat- 
ingly and be sure of success. There must 
frequently be modifications and adapta- 
tions. For this reason I regret that so 
many physicians have written largely upon 
the topic for the special use of the laity. 
A little knowledge, as we know, is a dan- 
gerous thing; imperfectly assimilated infor- 
mation may readily lead to disaster. But 
I must single out at least two books for 
special commendation: Holt's "Care and 
Feeding of Children," and Kerley's- " Short 
Talks with Young Mothers." These are 
extremely well written and have done a 
great deal for the American mother and 
baby. Nevertheless, they have probably 
done more good in an indirect way, for the 
general practising physician has taken them 
up, using them as text-books and making 
intelligent and scientific use of the princi- 



FEEDING THE CHILD 55 

pies and methods discussed. The thoroughly 
educated American mother may read these 
books with interest and profit, but the 
woman with mediocre intelligence cannot, 
and she must rely imphcitly upon the ad- 
vice of her physician. 

The feeding of older children may con- 
sist in general of the foods usually taken 
by sensible adults. Condiments and highly 
seasoned food-stuffs must be avoided, of 
course, while ample variety is essential. 
Emphasis should be placed upon mastica- 
tion; the proper chewing of food is abso- 
lutely necessary. But the practice need not 
be carried to an absurd extreme, such as 
the exaggerated chewing of milk soups and 
fine cereals. A Httle study of the physio- 
logical action of the stomach and intestinal 
juices will show that digestion and assimi- 
lation do not depend entirely upon masti- 
cation or the teeth, highly important as 
these are. 

I will add here a few tables and rules 
that will be found very helpful, and in some 
cases invaluable. 



56 MOTHER AND CHILD 

Milk Don'ts 

[Issued originally hy the Kansas City Health 
Board Bulletin^ 

Don't buy milk unless you are sure that it is 

clean. 
Don't expose milk or its container to the sun for 

an indefinite time. 
Don't put milk in a vessel that has not previously 

been scalded. 
Don't cool milk in vessels that are used for other 

purposes. 
Don't keep milk in the same compartment of the 

refrigerator with other eatables. It should 

be borne in mind that milk absorbs odors as 

well as germs. 
Don't leave milk bottles uncovered. 
Don't let the milk bottles stand unwashed after 

use. Wash them at once. 
Don't fail to rinse the bottle in cold water before 

scalding. 
Don't use any but fresh milk for the baby. 
Don't give the baby a milk mixture prescribed by 

a neighbor. 
Don't keep the milk warm all the time. Germs 

grow. 
Don't use a thermos bottle to keep baby's milk 

warm. 
Don't blow the milk to cool it. 
Don't heat the milk a second time before feeding 

it to the baby. 



FEEDING THE CHILD 57 

Don't moisten the nipple with your own saliva 
before putting it into the baby's mouth. 

Don't rescue dying flies from the milk and then 
use the milk. If you are a good housekeeper 
no flies will get into the milk. 

Don't drink milk rapidly. It is food and drink, 
and cannot be digested quickly. 

Don't accuse the milk dealer of serving sour milk 
until you have investigated your own hand- 
ling of it. 

Don't forget that ice is the best preservative for 
milk — see that it is about the milk bottle or 
container instead of being used for ice water 
or eaten by the children. 

Nursing Intervals 

[Compiled hy Dr. H. Edwin Lewis, Editor-in- 
Chief of " American Medicine "] 



Age 
From birth to 4 weeks, 
From 4 to 6 weeks. 
From 6 to 8 weeks, 
From 2 to 4 months. 
From 4 to 10 months, 
From 10 to 12 months, 3 " 5 





No. of feed- 


• No. of 


Interval 


ings in 24 
hours 


night 
feedings 


2 hours 


10 


2 


2 « 


9 


lto2 


21/2 " 


8 


1 


3 " 


6 





3 « 


6 






68 MOTHER AND CHILD 

Scheme for Feeding Babies 

\_Diet of the Society of the Lying-in Hospital, 
New York City^ 

First Day — Give from nursing bottles 30 c. c. 
(1 ounce) of 6 per cent sugar water every 
3 hours, from 6.45 p. m. to 9.45 p. m., inclu- 
sive, and if necessary one bottle at 3.45 a. m. 

Second Day — 30 to 45 c. c. (1 ounce to 1% 
ounces) of Formula No. I in nursing bottle, 
every 2 hours from 6.45 a. m. to 10.45 p. m., 
and 3.45 a. m. — ten feedings. 

Third Day — Same as second day. 

Fourth Day — If there is milk in mother's breast, 
nurse every 2 hours as on second day. If 
there is no milk in mother's breast, 30 to 45 
c. c. (1 ounce to l^/^ ounces) of Formula No. 
II every 2 hours, as on second day. 

Fifth and Sixth Day — For breast-fed babies ten 
feedings, as on second day. For bottle-fed 
babies, same as fourth day. 

Seventh to Fourteenth Days — For breast-fed 
babies, ten feedings. For bottle-fed babies, 
30 to 75 c. c. (1 ounce to 2% ounces) of 
Formula No. Ill for ten feedings. 

Formula 

Sugar Solution 6 per cent : 

Take 30 grams (1 ounce) sugar of milk and 
dissolve in 500 c. c. (1 pint) boiled water. 



FEEDING THE CHILD 59 

FORMULA NO. I 

Fat, 0.5 per cent; sugar, 6 per cent; proteid, 0,5 
per cent: 

Take 6 per cent sugar solution, 7 parts. 
Plain milk 1 part, 60 c. c. (2 ounces) lime water 
for every 500 c. c. (1 pint) of food mixture. 

FORMULA NO. II 

Fat, 1 per cent; sugar, 6 per cent; proteid, 0,5 
per cent : 

Take 6 per cent sugar solution, 7 parts ; 12 per 
cent cream l/^ part ; milk % part. 

60 c. c. (2 ounces) lime water for every 500 c. c. 
(1 pint) of food mixture. 

FORMULA NO. Ill 

Fat, 1.5 per cent; sugar, 6 per cent; proteid, 0.5 
per cent: 

Take 6 per cent sugar solution, 7 parts ; 12 per 
cent cream 1 part. 60 c. c. (2 ounces) lime 
water for every 500 c. c. (1 pint) of food 
mixture. 

FORMULA NO. IV 

Fat, '2 per cent; sugar, 6 per cent; proteid, 0.6 
per cent: 

Take 6 per cent sugar solution, 5 parts ; 12 per 
cent cream 1 part. 



60 MOTHER AND CHILD 

60 c. c. (2 ounces) lime water for every 500 c. c. 
(1 pint) of food mixture. 

FORMULA NO. V 

Fat, 2,6 per cent; sugar, 6 per cent; proteid, 0,8 
per cent: 

Take 6 per cent sugar solution, 4 parts ; 12 per 

cent cream 1 part. 
60 c. c. (2 ounces) lime water for every 500 c. c. 

(1 pint) of food mixture. 

Notes 

1. For every 500 c. c. (1 pint) of food mixture 

add 60 c. c. (2 ounces) of lime water. 

2. 12 per cent cream is the top fifth of a bottle 

of milk after standing about 5 hours. 

3. It is the top 200 c. c. (7 ounces) of 1,000 c. c. 

(1 quart) of milk after standing about 5 
hours. 

4. If the milk is of rich quality the top 240 c. c. 

(8 ounces) can be taken. 

5. Up to two weeks the amount of each feeding 

is 30 c. c. (1 ounce) to 75 c. c. (2% ounces), 

according to weight, digestion and capacity. 
From two to five weeks the amount of each feeding 

is 60 c. c. (2 ounces) to 100 c. c. (3% 

ounces). 
Number of daily feedings, 10. From 6.45 a. m. to 

10.45 p. M. From 10.45 p. m. to 6.45 a. m., 

one feeding should suffice. 



FEEDING THE CHILD 61 

Feeding Older Children 

[From Dr. H, Edwin Lewises " Diet for 
the Sick "] 

A good working formula for a child 18 to 30 
months old is : 

7 A. M. New milk 8 oz., yolk of a soft-boiled 
egg, two thin slices of bread and 
butter or else milk and two table- 
poonfuls of well-cooked oatmeal or 
wheaten grits with sugar and cream. 
10 A. M. Milk 6 oz., soda biscuit or bread and 
butter. 
2 p. M. One tablespoonful of rare mutton 
pounded to a paste or scraped beef, 
bread and butter, mashed potatoes 
moistened with meat juice (dish 
gravy), a saucer of junket or else 
a breakfast cupful of beef, mutton 
or chicken broth, a thin slice of 
stale bread, a saucer of rice or milk 
pudding. 
6.30 p. M. A breakfast cupful of milk with bread 

and butter or soft milk toast. 
This being merely a type of diet, it should be modi- 
fied in accordance with the growth of a child, 
or the activity of its digestive function. 
From the third to the sixth year one may allow: 
Fresh milk, cream, eggs in any form excepting 
fried. 



62 MOTHER AND CHILD 

Meats : Preferably beefsteak, mutton chop, under- 
done roast beef or lamb, white meat of 
chicken, fresh fish boiled or broiled, broths, 
soups. 

Vegetables: Baked potato with cream, beef juice 
or dish gravy of roast meats. Green vege- 
tables: Asparagus tips, spinach, stewed cel- 
ery, string beans, fresh peas. Cereals : Oat- 
meal, wheaten grits, hominy, rice, farina, 
arrowroot, bread and crackers. 

Desserts: Junket, plain custard, plain rice pud- 
ding, ice cream occasionally. 

Fruits : Oranges, baked apple, stewed prunes. 

The following are forbidden to young children: 

Ham, sausage, pork of all description, salt fish, 
canned and dried beef, goose, duck, game, kid- 
ney, liver and bacon, meat stews, dressing 
from roast meats, fried vegetables, cabbage, 
carrots, potatoes (except boiled or roasted), 
raw or fried onions, raw celery, radishes, let- 
tuce, cucumbers, tomatoes (raw or cooked), 
beets, eggplant, and green corn. All hot 
breads and rolls, griddle cakes, sweet cakes, 
especially when fruited or frosted. All nuts, 
candies, pastry, salads, jellies, syrup and 
preserves, tea, coffee, cocoa, wine, beer, cider, 
all dried, canned or preserved fruits, bananas. 



FEEDING THE CHILD 63 

Comparative Table 
\_Compiled hy Professor W, 0. Atwater'] 

A child under 2 requires 0.3 the food of a man 

doing moderate work. 
A child of 3 to 5 requires 0.4 the food of a man 

doing moderate work. 
A child of 6 to 9 requires 0.5 the food of a man 

doing moderate work. 
A child of 10 to 13 requires 0.6 the food of a man 

doing moderate work. 
A girl of 14 to 16 requires 0.7 the food of a man 

doing moderate work. 
A boj of 14 to 16 requires 0.8 the food of a man 

doing moderate work. 

Professor W. Gilman Thompson has laid 
down a few simple general rules, in his book 
" Practical Dietetics " : 

1. In acute illness reduce and dilute the food 

at once. 

2. Allow time for meals. 

3. See that the food is thoroughly masticated. 

4. Do not allow nibbling between meals. 

5. Do not tempt the child with the sight of rich 

and indigestible food. 

In conclusion, do not force the child to 
eat against its will, but examine its mouth, 



64 MOTHER AND CHILD 

which may be sore from erupting teeth ; and 
examine the food, which may not be prop- 
erly cooked or flavored. If good food is 
refused from peevishness merely, remove it 
and do not offer it again before the next 
mealtime. Forced feeding of children is 
entirely unnecessary and should never be 
practised, unless under medical orders. 

Do not allow older children to " stuff," 
and see that ordinary meals are taken at 
regular hours under proper supervision. 



VI 

FEEDING IN DISEASE 

A FRENCH savant, in an earlier 
period, proclaimed that starvation 
and depletion were the two most 
essential dietary requirements during acute 
febrile illness. The French theory was ad- 
hered to religiously by the medical profes- 
sion for some time, until an English phy- 
sician named Graves questioned the theory 
of the French scientist and after a series of 
tests and experiments came to the conclu- 
sion that to starve and deplete was abso- 
lutely wrong. Modern research has con- 
firmed this view. We no longer practise 
the *' starvation " treatment in fevers, for 
we have learned that it does not have any 
beneficial effect, as was formerly erroneously 
beheved. On the other hand, though we 
no longer starve, neither do we " stuff " ; 
for there is a happy medium with respect to 
feeding during sickness, though each case 



66 MOTHER AND CHILD 

calls for individual study and requires in- 
dividual treatment. 

Different diseases demand different diet 
and careful consideration. It would be 
folly, for instance, to treat scurvy with any- 
thing but a fruit or vegetable diet, as such 
food would be necessary not merely as a 
dietary consideration, but also from a cura- 
tive standpoint. Again, no modern phy- 
sician would attempt to treat scrofula or 
tuberculosis without fats and oils as ad- 
juncts to medicinal procedure. 

In prescribing foods we should follow a 
simple rule — the rule of conmion sense. 
The object should be to maintain bodily 
strength and keep up nutrition while taxing 
the digestive organs as little as possible, so 
that assimilation is properly secured. Ex- 
pensive or rare foods are not necessary. 
Health may be restored without extrava- 
gant demands upon the family exchequer. 

There is still, however, a tendency to feed 
too much; and though public opinion is be- 
coming better informed, the physician fre- 
quently has to combat the anxiety and 
continued pressure of the family with re- 
gard to increasing the diet for a sick child. 



FEEDING IN DISEASE 67 

It seems to be a general opinion that if a 
well-nourished child with a high fever does 
not eat for twenty-four to forty-eight hours 
there is serious danger, and that the child 
will become much worse unless prompt mea- 
sures are taken. This, under usual condi- 
tions, is a fallacy. Discretion in diet during 
sickness is essential, and children should not 
have more food than is absolutely necessary. 
Nature is sufficiently clever at her own busi- 
ness, and as a rule where there is no appetite 
there is no necessity for forced nourishment. 
Professor Gilman Thompson ^ puts this 
very clearly: 

" If the appetite holds out, it may do no 
harm to allow some little variety in the diet, 
but if the fever is high and the appetite 
fails, it is unnecessary to force the patient 
to take food. 

" As a rule, in fevers which are protrac- 
ted or severe, nourishment should be given 
in fluid form. To offer solid food is prac- 
tically to place in the alimentary canal for- 
eign bodies which merely ferment and 
putrefy, causing discomfort with flatus, 
fetor and diarrhoea." 

^ " Practical Dietetics/' page 423. 



68 MOTHER AND CHILD 

In all cases of acute illness the quality 
and quantity of the food must be reduced. 
Nourishment is necessary, but care in nour- 
ishment is vital. 

The strength of the patient must be rea- 
sonably maintained, but the mere loss of a 
little weight or the fact that feeding has 
been withheld temporarily should cause no 
alarm, for in the majority of acute febrile 
diseases the body loses some weight on ac- 
count of the increase of urea and the excre- 
tion of carbonic acid and water in greater 
volume than when in health. This slight 
temporary loss of weight is normal and need 
not be in any way disquieting. 

The preparation of the food for the pa- 
tient is of great importance. The ad- 
ministration of unsuitable food during ill- 
ness is infinitely worse than no food at all. 
Fortunately, the patient himself will in- 
variably rebel at taking unsuitable food. 
The fact, therefore, that food is rejected is 
not always due to the wilfulness or the 
physical condition of the patient. The fault 
may be found in the kitchen. Defective 
cooking and irregularly served meals are not 
conducive to an appetite at any time ; much 



FEEDING IN DISEASE 69 

less when the patient is ill and requires 
special consideration/ 

With regard to the quality and quantity 
of the food, it is scarcely necessary to say 
that purity and wholesomeness are the first 
requirements. The quantity must be regu- 
lated by the physician and the necessities 
of the patient. A voracious appetite is ab- 
normal and should not be satisfied. Only a 
certain moderate amount should be given, 
and always in small portions. 

The time for feeding depends upon the 
class of case that is being treated. Pa- 
tients who are totally helpless must be fed 
regularly and with the utmost care. But 
do not disturb a patient who is sleeping, 
unless the physician has given definite 
instructions. 

During convalescence, when attention 
should be directed to building up and in- 

^ ** Punctuality in serving meals should be carefully 
observed, for an appetite ready at the accustomed 
hour may fail if the meal is delayed. There is much 
unconscious habit in relation to eating. The time for 
cooking meals should be carefully considered with re- 
gard to the time for serving it.'* — " Practical Die- 
tetics, with Reference to Diet in Disease/' by Alida 
Frances Pattee. 



70 MOTHER AND CHILD 

creasing the bodily weight, care must be 
exercised not to overload the stomach. 
Food in too large a quantity or of unde- 
sirable richness will probably upset the 
digestive system to such an extent that the 
condition of the patient will become worse 
and a relapse will follow. 

Liquid food is unquestionably the most 
suitable. As all food is eventually changed 
into liquid form by the digestive process be- 
fore the essential elements are taken up by 
the blood, it is obviously desirable to save 
the system as much work as possible and 
administer the food in the form that it will 
ultimately have to assume. 

The liquids of most value are water and 
milk. Both can be used with decidedly 
beneficial results. Water is especially essen- 
tial in cases of fever, while milk, given in 
the right proportions, is equally indis- 
pensable for children. Beef tea, barley 
water, rice water and lemonade are also 
very valuable. Lemonade, in particular, 
works admirably in acute diseases with high 
fever. Its diuretic and thirst-quenching 
properties are greatly appreciated both by 
patient and physician. Koumiss and butter- 



FEEDING IN DISEASE 71 

milk may be used in suitable cases. Clear 
soups are refreshing, nutritious and slightly 
stimulating. Semi-liquids are also suitable, 
such as purees; these may be given alone 
or with well-cooked arrowroot, rice or flour. 
Semi-solids may be introduced gradually 
when the fever diminishes and the patient's 
stomach can tolerate them. At this stage 
the building up process can be accomplished 
more effectively by the use of semi-solids, if 
well chosen, in preference to liquids: soft 
eggs, meat jellies, well-cooked oatmeal, milk 
or cream toast, tapioca or rice pudding, 
gelatin added to other foods, chicken or 
calf's foot jelly. 

There is still some dispute with regard to 
the merits or demerits of alcohol. It is often 
asserted that it serves as a food and that 
after its absorption it helps to prevent tissue 
waste. We are also told that it has strong 
fever-reducing properties. In Germany 
and France, particularly, beer and wines are 
used during fever, but the results do not 
warrant any but the most moderate use of 
alcohol in such forms in disease. Further, 
it is always wiser, and sometimes absolutely 
necessary, to keep alcohol in reserve as a 



72 MOTHER AND CHILD 

stimulant in emergencies — a function which 
would be enfeebled, perhaps hopelessly, by 
previous habitual use/ 

But, except in such casese of absolute 
emergency, the depression that follows the 
administering of alcohol outweighs the ad- 
vantages of the temporary stimulation which 
it produces. I have been connected both 
with hospitals which uesd alcohol in the 
form of whiskey for treating disease, and 
with hospitals which used no whiskey under 
any circumstances ; and from my own expe- 
rience I certainly cannot see that the whis- 
key-giving doctor gets, to say the least, any 
better results or cures his patients any more 
quickly than the doctor who discards whis- 
key altogether. Alcohol is a poisonous 
medicine and should be administered with 
extreme caution as a medicine only. While 
it unquestionably has antipyretic qualities, 

^ "If alcohol is not required for its stimulating 
effect upon the circulatory or the nervous system, it 
is better to withhold it, for in continued fevers 
emergencies may at any time arise in which it is im- 
peratively demanded to strengthen the failing powers 
or aid in controlling the exhaustion of delirium.'* — 
Professor W. Oilman Thompson in " Practical Die- 
tetics/' page 428. 



FEEDING IN DISEASE 73 

I doubt extremely if it has any nourishing 
or tissue-building qualities; and I prefer 
distinctly to give my patients the full bene- 
fit of that doubt. 

Forced feeding is kt times necessary in 
cases of disease, especially when we are 
dealing with throat troubles where there is 
great difficulty in swallowing, or with stom- 
ach irritability, or with patients who per- 
sistently refuse food when nourishment is 
essential. The usual methods of administer- 
ing food in such cases are through a stomach 
tube or through the nose, and a physician 
or trained nurse is needed to carry out such 
a procedure. Rectal feeding is seldom used 
except in hospitals. It should only be re- 
sorted to when the stomach is absolutely un- 
able to retain food, and must never be 
attempted except by a trained nurse or a 
physician. 

Simplicity, patience and common sense 
are the three chief requirements in feeding 
the sick. I have already indicated the gen- 
eral principles and methods, but it is im- 
possible to lay down specific rules to be 
followed in all individual cases. Every case 
requires its special treatment; but if the 



74 MOTHER AND CHILD 

simplicity, patience and common sense that 
I insist upon are employed throughout, half, 
at least, of the work of the physician will 
be done for him, and more than half of the 
patient's suffering will be prevented. 



VII 

THE IMPORTANT INFECTIOUS AND CONTA- 
GIOUS DISEASES OF CHILDHOOD 

A PHYSICIAN should always be con- 
sulted in cases of serious sickness. 
It must not be forgotten that there 
is a science of health, as there is a science 
of biology or chemistry, of architecture 
or aviation, or even of humble but use- 
ful plumbing. And though most people 
have contrived, without being speciahsts, to 
pick up some of the rudiments of several of 
these sciences, they leave the building of 
houses and the repairing of broken pipes to 
the men who have been trained in the science 
that governs their vocations and have 
learned by experience to apply that training 
most effectively in their daily work. Yet 
many of those who would not attempt to 
repair a cracked chimney or fix a defective 
stove will nevertheless try quite confidently 
to practise medicine. It is an amusing but 



76 MOTHER AND CHILD 

dangerous form of egotism. It is better to 
practise common sense and avail ourselves 
of the skill of those who have spent many 
years of their lives in learning what to do, 
and how and when to do it. 

Emergency and first-aid care, however, 
should be universally taught. People ought 
to know what to do while they are waiting 
for the physician. The first principles of 
ordinary sickness can be grasped with rea- 
sonable intelligence and care; but the tech- 
nicalities and complexities must be left to 
the physician. I am emphasizing this point 
strongly because my experience has shown 
me far too many regrettable cases of false 
confidence on the part of the laity, leading 
to grave disaster. Human life is too valu- 
able to be trifled with. I am not writing 
this book, therefore, to try to transform 
every mother into an expert doctor. Ex- 
perts in medicine, as experts in engineer- 
ing, are not manufactured by a single text- 
book. I am trying to give the mother a 
clearer knowledge of the principles that it 
is essential for her to know, so that she may 
understand the nature and difficulty of the 
physician's work, and, without the false con- 



CHILDHOOD DISEASES 77 

iidence or false fear of ignorance, be able to 
play her part satisfactorily in emergencies. 

While some of the simpler diseases are 
capable of cure through intelligent home 
treatment, most of the contagious diseases 
require the constant attention of a physi- 
cian. But, from every point of view, it is 
desirable for parents to have sufficient ele- 
mentary knowledge to recognize the pri- 
mary symptoms of illness and realize at 
once whether it is a serious case or a more 
simple disorder that need occasion little 
worry. 

Many diseases of childhood are due di- 
rectly to disordered digestion. So much 
stress has been placed by parents on the 
regular gaining of weight by their children, 
that they are apt to overestimate the serious- 
ness of any failure to reach the prescribed 
standard. In many cases the quantity of 
the food is unnecessarily increased, or an 
attempt is made to improve the quality by 
adding cream or eggs, or by feeding be- 
tween the regular periods. This is a mis- 
take. Any undue loss of weight in children 
suggests either improper feeding or the 
beginning of sickness. If the food is not 



78 MOTHER AND CHILD 

being properly assimilated, it is absurd to 
give more or richer food in order to correct 
a condition brought about by improper 
feeding. 

If the child does not gain reasonably in 
weight, or loses its appetite, or has a little 
nausea, withdraw all food for a day, ad- 
minister a large dose of castor oil, and then, 
unless there is an immediate improvement, 
send for your physician. 

Apart from stomach troubles, the diseases 
of childhood which are most common, and 
which seem to be almost unpreventable dur- 
ing certain ages, are the following — ar- 
ranged, for convenience of reference, in 
alphabetical order: 

BRONCHITIS AND PNEUMONIA 

CHICKEN POX 

CROUP 

DIPHTHERIA 

INFLUENZA ( GRIPPE ) 

MEASLES 

MENINGITIS 

MUMPS 

PNEUMONIA (see bronchitis) 

SCARLET FEVER ( SCARLATINA) 



CHILDHOOD DISEASES 79 

TONSILITIS 
WHOOPING-COUGH 

I will deal briefly with each, describing 
the symptoms, the general course of the 
disease and the proper treatment. 

Bronchitis and Pneumonia 

These diseases should be considered to- 
gether in a book of this kind. When they 
occur in young children they resemble each 
other and are occasionally associated. They 
are diseases which should be treated only by 
physicians, and the family must foUow the 
physician's directions implicitly. 

Bronchitis is an inflammation of the bron- 
chial tubes, associated with cough, expectora- 
tion and fever. There are several varieties. 

Pneumonia is an acute disease of the 
lungs caused by specific bacteria. 

Symptoms of Bronchitis: Slight fever; 
cough, at first dry and afterwards becoming 
quite loose, with profuse expectoration; 
chilliness, malaise, feeling of tightness round 
the chest. 

Symptoms of Pneumonia: This disease 
invariably begins with a pronounced chill, 



80 MOTHER AND CHILD 

followed by high fever reaching 104-105 
degrees F., with sharp pain in the side and 
flushed face. The patient may be delirious. 
Respiration and pulse are rapid. The cough 
is irritating, at first dry and afterwards 
with streaks of blood. The tongue is badly 
coated; breath bad; urine diminished in 
quantity and frequently containing albumin. 

Treatment: Sunmion a physician imme- 
diately and leave the entire care of the child 
in his hands. A trained nurse is a valuable 
adjunct, as both diseases need a great deal 
of care and nursing. Avoid all unnecessary 
exposure and see that the child is properly 
clothed. Remember that no case of bron- 
chitis or pneumonia is ever too bad for re- 
covery, while, on the other hand, no case is 
so slight as not to require the most careful 
watching. 

Patent medicines advertised as cures for 
coughs, colds, pneumonia and bronchitis 
should never be used. They invariably con- 
tain opiates, and the best that can be hoped 
from them is that they will not do much 
harm. 

Pneumonia jackets and poultices, tur- 
pentine stupes, camphorated oil dressings, 



CHILDHOOD DISEASES 81 

mustard plasters and similar methods of 
treatment can be used most effectively only 
under the supervision of a trained nurse and 
under the direction of a physician. 

The outdoor treatment of these diseases 
is often very beneficial, but it is absolutely 
essential that it should be prescribed and 
controlled by a physician. 

Chicken Pox 

Chicken Pooc, also called " Varicella," is 
a mild, contagious disease accompanied by 
a rash or eruption on any part of the body. 
This eruption disappears within three or 
four days by drying up. 

The period of incubation is up to 20 days. 
The exciting cause of the disease is un- 
known. It is in no way associated with or 
related to Small Pox. 

Symptoms: Slight fever, and occasion- 
ally gastric disturbances, particularly in 
young children. 

The eruption appears on several parts of 
the body as round red spots the size of a 
small bean or pea, filled with a light fluid 
or serum. This blister-like eruption lasts 



82 MOTHER AND CHILD 

about two or four days, when the fluid in 
the vesicles becomes sHghtly turbid and then 
dries up, leaving a dark-brownish crust. In 
a short time this crust falls off, leaving a 
slight scar, which is often present for several 
weeks. Itching is sometimes quite pro- 
nounced. 

Treatment: The child should be isolated 
until the skin is clear — a period of about 
four weeks. 

The child should not be allowed to scratch 
itself. To prevent this, either tie the hands 
or place mittens upon them. 

Keep the bowels well open and place the 
child on a restricted diet. 

Allay the itching by swabbing with a 
weak solution of alcohol and water — one 
ounce of alcohol to a half -pint of cold water. 
Afterwards apply some simple ointment, 
such as zinc oxide or pure vaseline. 

Quarantine is advisable until the child is 
perfectly well. 



CHILDHOOD DISEASES 83 

Croup 

[Varieties : Simple Croup — Catarrhal 
Croup — Spasmodic Croup — Pseudo- 
Croup — Laryngitis Stridula] 

This is one of the diseases of childhood in 
which we have alarming symptoms, but very 
seldom fatal results. 

There are various degrees of the disease. 
It usually comes on about midnight, when 
the child is awakened suddenly. If the at- 
tack is mild, the breathing is simply noisy 
while the breath is being drawn. When the 
attack is more severe, the patient is awak- 
ened with a hollow " croupy cough," the 
voice being quite hoarse. Perspiration 
covers the face and the patient gasps for 
breath. Such an attack may recur for sev- 
eral nights, while during the daytime the 
child is apparently well. The symptoms at 
times become more pronounced. For sev- 
eral days previous to the attack the child 
may develop " snuffles," or have a cold in 
the head, associated with mild fever. These 
symptoms, however, are the exception rather 
than the rule, for the majority of children 



84 MOTHER AND CHILD 

become sick during the night without any 
apparent previous warning. Occasionally 
the patient will complain of slight sore 
throat; sometimes a little pain is noticed 
over the larynx; there is a changed general 
condition; the child loses its appetite. 

Treatment: Medication should not be 
given by the mother unless the disease is 
severe and the symptoms urgent. The 
family physician should be sent for without 
delay, especially if the child has difficulty in 
breathing. In the meantime, should the 
family be obliged to treat the case tem- 
porarily, 15 to 20 drops of Syrup of Ipecac 
should be administered every 15 minutes un- 
til the child vomits freely. The patient should 
be placed in a warm room and have hot 
poultices, or cloths wrung out of hot water, 
placed round the throat and over the chest. 
In the modern apartment houses, where hot 
water is always available, I have found it 
very convenient to take the patient into the 
bathroom and turn the hot water into the 
tub. The steam which fills the room, if the 
water is hot enough, is very soothing to the 
patient. 

Perhaps the most universally used appa- 



CHILDHOOD DISEASES 85 

ratus for croup is the so-called " croup 
kettle." The Holt Croup Kettle is one of 
the best, but any will answer the purpose. 
The ordinary tea-kettle, if kept boiling 
under a sheet made into a tent over the crib, 
will also be found satisfactory. It is bene- 
ficial to put into the boiling water a few 
teaspoonfuls of compound tincture of ben- 
zoin. The inhalation of steam impregnated 
with benzoin is decidedly soothing and fre- 
quently gives much relief. Hot drinks 
should be administered, and also a laxative. 
The child should be kept indoors for several 
days after the acute attack has subsided. 

This disease very rarely becomes chronic, 
though it will sometimes linger, in a more 
or less mild form, for a period which taxes 
the patience both of mother and child. 

Diphtheria 
[Membranous Croup] 

This is a more dangerous disease, and it is 
utterly impossible for the mother to deter- 
mine whether the child has the simple mild 
croup or the more severe diphtheric form. 
The same temporary treatment is effica- 



86 MOTHER AND CHILD 

cious, but the services of a physician are 
indispensable. 

Isolation is of supreme importance. 

Diphtheria is an acute, highly contagious 
disease caused by what is known as the 
Klebs-Lofler bacillus, and characterized by 
sore throat and enlarged glands. 

The period of incubation varies from 3 to 
12 days. 

Symptoms: The patient usually com- 
plains of a sore throat. Occasionally this 
is preceded by a chill. General malaise and 
fever running from 101-103 are present. 
As soon as the poisonous toxins of the dis- 
ease begin to be absorbed, as it were, into 
the general circulation, the patient has a 
rapid pulse, which is sometimes quite feeble. 
The bowels become constipated, headache 
is severe and prostration extreme. The 
urine frequently contains albumin and the 
patient passes very little. Difficulty in 
swallowing is experienced, as the throat is 
swollen and the glands of the throat are 
enlarged. A dark, grayish-white membrane 
appears on the back and sides of the throat 
and tonsils. 

One characteristic symptom of diphtheria 



CHILDHOOD DISEASES 87 

is the membrane which, when rubbed 
off the throat, leaves a bleeding surface. 
This membrane is found also in the nasal 
cavities. 

It is sometimes difficult at first to dif- 
ferentiate diphtheria from scarlet fever or 
tonsilitis. A bacteriological examination of 
throat exudate is invariably made by up-to- 
date physicians. This, of course, determines 
the diagnosis beyond doubt. 

Since antitoxin became the specific for 
diphtheria, the mortality from the disease 
has been reduced to a minimum. 

Treatment: This consists in injecting 
antitoxin. A physician should be sum- 
moned immediately, a bacteriological exam- 
ination made, and antitoxin given as soon 
as possible. 

No other treatment for this disease is 
worth consideration. 

Influenza 

[La Grippe] 

This is an acute, contagious disease char- 
acterized by cold in the head, with coughing 
and extreme prostration. 



88 MOTHER AND CHILD 

The immediate cause is a germ known as 
the bacillus of Pfeiffer. 

The disease is extremely prevalent among 
children during winter. It is ushered in 
rather rapidly with chilliness, pain in the 
head and back, and temperature running up 
to 103 or higher. Prostration is very pro- 
nounced. Catarrhal symptoms, such as 
sneezing, running at the nose, watery eyes, 
are generally severe. Sore throat and a dry 
bronchial cough are invariably present — 
the cough is especially irritating. Intestinal 
symptoms are at times distinctly disagree- 
able, the patient suffering from severe 
diarrhoea which will be characterized by 
numerous green watery stools. Blood and 
mucus are not infrequently present. Ner- 
vous manifestations such as hysteria, de- 
pressed spirits, peevishness, general debility 
with fretfulness, are common symptoms. 

There are frequent complications, such as 
pneumonia, pleurisy, bronchitis and middle- 
ear disease or " otitis." As influenza leaves 
the patient in a weakened and depressed 
condition, these complications are danger- 
ous and require the most careful watching. 

Treatment: This consists of absolute 



CHILDHOOD DISEASES 89 

rest in bed, and a liquid diet. The symp- 
toms are treated as they arise — no specific 
general treatment is known. Much can be 
accomplished by efficient nursing. Hot 
water bags to the head and spine, quinine 
and phenacetin with salol, seem to be useful 
remedies. Stimulants are occasionally re- 
quired. A physician should be in constant 
attendance, as the disease usually runs a 
protracted course, especially when complica- 
tions set in. 

Measles 

Measles is a highly contagious disease 
developing rather gradually. Its incuba- 
tion period is about two weeks. The con- 
tagion is unquestionably associated with 
nasal secretions. No germ has yet been 
isolated. 

Symptoms: The child should have a feel- 
ing of lassitude for some days — also chilly 
sensations. Cold in the head is at times 
pronounced. A slight cough and watering 
of the eyes — the eye symptoms of measles 
are generally characteristic. Children will 
object to look into a bright light, because of 
the consequent eye irritation. This condi- 



90 MOTHER AND CHILD 

tion is known as photophobia. For a few 
days the child may sneeze. The fever comes 
on quite rapidly and the temperature re- 
mains from 101% to 103% F. for about 
two days, after which there is a slight remis- 
sion. About this time the eruption appears 
and the fever increases to its original high 
point, or even much higher. When the rash 
is completely developed, the fever reaches 
its maximum, which is usually between 103 
and 105 F. The temperature generally re- 
mains quite high for two or three days, and 
then, unless complications set in, drops 
sharply to about normal. 

During the height of the disease the 
symptoms previously mentioned increase in 
severity. The inside of the eyelids becomes 
more inflamed. Occasionally the patient 
will have vomiting and diarrhcea. 

The eruption of measles appears about 
the third or fourth day of the sickness, upon 
the face and the chest, spreading quickly 
over the whole body. The rash is a small 
red papula, which forms in groups resem- 
bling flea bites. These groups quickly 
coalesce until the body is covered with one 
red mass. In a few days the eruption fades 



CHILDHOOD DISEASES 91 

and becomes quite pale, while a fine branny 
peeling of the skin begins. 

*' Koplich's Sign " of measles occurs in 
about 90 per cent of cases. There appear 
on the mucous membrane of the mouth nu- 
merous small, bluish-white spots, which are 
surrounded by a reddish area. These little 
specks occur about one or two days before 
the skin eruption and last from three to 
four days. When the spots are recognized 
it becomes easy to make a correct diagnosis. 

Treatment: Isolate the patient com- 
pletely. Notify the physician at once, and 
also see that the health authorities are ap- 
prised of the fact that a contagious disease 
is being treated. Please remember that it 
is the duty of every family to co-operate in 
every way with the health authorities, both 
for their own protection and the protection 
of others. Deception of the health authori- 
ties on the part of the general public is far 
too prevalent, or measles, scarlet fever and 
other highly contagious diseases would 
rapidly become less harmful, while eventu- 
ally epidemics of such diseases would be 
unknown. 

The patient should be placed in a well 



92 MOTHER AND CHILD 

ventilated dark room, on account of the irri- 
tating eye symptoms. Warmth should be 
maintained, and a laxative and warm drink 
administered to bring out the rash. A 
liquid diet is necessary. 

The fever and cough need special atten- 
tion, which can only be given satisfactorily 
by a physician. 

During the scaling of the skin, the pa- 
tient should be anointed daily with vaseline. 

Measles is a serious disease, notwithstand- 
ing the opinion of the laity in regard to it. 
There are so many possible complications 
that there can be no real certainty as to the 
next development. A physician should be 
in constant attendance, and he should exam- 
ine the child carefully at every visit. The 
action of the heart and lungs should be 
examined, and a specimen of the urine 
should be given to him. 

During convalescence, see that the pa- 
tient has plenty of rest, fresh air and tonic 
treatment. 

Mumps 

Mumps is a contagious disease character- 
ized by a swelling and inflammation of the 



CHILDHOOD DISEASES 93 

gland in front of the ear known as the 
Parotid Gland. The disease is also called 
Parotitis. It chiefly affects children, al- 
though adults, particularly the male sex, 
are frequently susceptible. 

The contaminating virus, which is highly 
contagious, is found in the saliva. The sali- 
vary glands are often involved. No defi- 
nite micro-organism has yet been discovered. 

Patients can have more than one attack, 
but the disease is not at all dangerous. 

The incubation period is from 7 to 14 
days. 

Symptoms: For several days the child 
will feel indisposed. The disease frequently 
starts with a chilly sensation, followed by 
fever, rising to about 103 F. 

Swelling in front of the ear becomes pro- 
nounced. One or both sides of the face 
may be affected. Movement of the jaw 
becomes decidedly painful, and the features 
are distorted owing to the swelling. Often 
during the course of the disease the swell- 
ing and pain will subside in the face and 
reappear in the testicle of the male adult, 
or in the ovary and breasts of the female. 

The diagnosis of the disease is simple. 



94 MOTHER AND CHILD 

If, however, there is any question, let the 
patient take the juice of a lemon and hold 
it in the mouth for a few seconds before 
swallowing. If mumps be present the pa- 
tient will almost immediately have an acute 
pain at the angles of the jaw. 

Treatment: This is very simple and con- 
sists chiefly in nursing. Administer, as in 
acute diseases, the customary laxative. Hot 
poultices or hot flannel-cloths to the face 
and neck will give relief. The patient should 
be kept on a simple diet. Should the testi- 
cles become quite painful, cover them with 
a cloth saturated with lead and opium wash, 
keeping wet all the time, or apply a ten 
per cent Ichthyol ointment. Either of these 
remedies can be obtained easily at any drug 
store. 

Scarlet Fever or Scarlatina 

Scarlet Fever is one of the most danger- 
ous contagious diseases that the physician 
is called upon to treat. No case of scarlet 
fever should be considered mild at any time, 
on account of the various complications 
which are always possible. It requires the 
greatest watchfulness on the part of both 



CHILDHOOD DISEASES 95 

nurse and physician, and this vigilance can- 
not be relaxed with safety until the patient 
has been well apparently for at least five 
or six weeks. 

The incubation period is from 1 to 7 days. 
The disease is associated with high fever 
and rapid pulse, a scarlet rash, a sore throat, 
and a peculiar tendency to involve the kid- 
neys, setting up acute Bright's disease. 

The disease generally begins with a chill, 
often with vomiting, and occasionally with 
convulsions. The tongue is heavily coated, 
quite red at the tip, looking very much like 
a strawberry — the so-called " strawberry 
tongue " of scarlet fever. The throat is 
intensely swollen, and the patient suffers 
great pain and has much difficulty in swal- 
lowing. The tonsils are generally covered 
with a membrane, and are greatly swollen. 

The fever reaches 105 F. in a few hours 
and remains high for several days, when 
it declines gradually to normal in about ten 
days, provided no complications exist. 

The patient is very restless, having severe 
headache, being unable to sleep, and at times 
going into delirium. 

The eruption of scarlet fever generally 



96 MOTHER AND CHILD 

appears rapidly on the neck, chest and ab- 
domen, spreading over the entire body. 
The characteristic point about the rash is 
that it disappears upon pressure, leaving 
a white surface which remains for a few 
seconds at a time. The rash is composed 
of minute bright red spots, coalescing or 
so closely associated as to form one mass 
of vivid scarlet color. Between the fourth 
and the sixth day the rash fades and the 
period of peeling begins. The epidermis 
of the entire surface of the body desqua- 
mates even to the palms of the hands and 
tips of the fingers. 

Treatment: Rest; liquid diet; isolation. 
Anoint the entire surface of the body twice 
daily — especially during peeling time — 
with cocoa butter, cold cream or vaseline. 
Encourage the patient to drink plenty of 
water. Do not attempt to treat the case, 
but send at once for a physician. A strict 
quarantine should be carried out and the 
health authorities notified at once. 

A protracted convalescence is the rule, 
and on account of the various complications 
it is wise to keep the patient in bed from 
five to eight weeks. 



CHILDHOOD DISEASES 97 

Physicians attending such cases should 
wear white gowns over their clothing and 
should be careful to wash their hands thor- 
oughly before and after visiting the sick 
room. Carrying the contagion from one 
patient to another is very easy, hence too 
much care cannot be used when treating 
such a case. 

The family should be kept away from the 
patient and should be instructed about using 
gargles and taking general hygienic care of 
themselves. 

I cannot emphasize the necessity of a 
physician too strongly. There are so many 
little details regarding hygiene, care of 
the case, quarantine and complication that 
the expert, trained mind is necessary to ac- 
complish the desired result. 

TOI^^SILITIS 

Tonsilitis is an inflammation of one or 
both tonsils. Young children with enlarged 
tonsils are particularly susceptible during 
the winter months. 

It is caused by exposure to wet or cold, 
especially if a child is debilitated or run 



98 MOTHER AND CHILD 

down from any cause. Rheumatic tendency 
has a predisposing influence. 

Symptoms: Frequently the child will 
have a chill, sore throat, headache, marked 
pain under the ears near the jaw. There 
is difficulty in swallowing and in talking — 
the voice sounds as if the mouth contained 
something. The tonsils will swell rapidly 
and be quite red. Frequently the so-called 
" crypts " or little holes in the tonsils are 
filled with a yellowish, offensive, cheesy 
mass, this being often expectorated when 
the patient is recovering. Often again, 
these small spots run together and form 
one large yellow patch upon the tonsil, 
somewhat resembling diphtheria. The fever 
runs up to 103-104 F. and remains rather 
high for several days. As the fever de- 
clines, so does the disease, which usually 
runs its course within a week. 

Treatment: Keep the patient as com- 
fortable as possible. Use small pieces of 
cracked ice, allowing them to melt in the 
throat. A cold compress to the outside of 
the throat is occasionally very beneficial. 
Gargling is of benefit provided the child 
can do it. DobelFs solution (procured at 



CHILDHOOD DISEASES 99 

any drug store) and hot water, in equal 
parts, or Listerine and hot water (in equal 
parts), is useful. A solution of peroxide 
of hydrogen with hot water will clear the 
throat well and is an excellent preparation 
to try before using other gargles. When 
gargles are used, they should be kept up 
continuously every two hours at least dur- 
ing wakeful hours. The bowels should be 
kept well open by large doses of salts or 
castor oil. Hot milk will not only act as 
a nutritious food but frequently will greatly 
relieve the painful throat symptoms. Ab- 
scesses occasionally develop and for that 
reason a physician should be in attendance. 

Whooping Cough 
[Pertussis] 

This is an infectious disease characterized 
by peculiar spasms of coughing ending in 
a profound " whoop." The disease is dis- 
tinctly dangerous, especially when young, 
delicate children contract it. 

The exciting cause is as yet unknown. 
The period of incubation is from 5 to 15 
days. 



100 MOTHER AND CHILD 

Symptoms: There are three separate 
stages — the first, or catarrhal stage ; the 
second, or paroxysmal stage ; and the third, 
or improvement stage. 

Catarrhal Stage: Sneezing, cold in the 
head, slight, dry cough, and moderate fever. 
These symptoms become more aggravated 
for about two weeks, and apparently resist 
all treatment, developing into the second 
stage. 

Paroxysmal Stage: This is the " whoop- 
ing " stage of the disease, during which the 
previous symptoms become much more ag- 
gravated. The cough is harsher, the eyes 
become deeply congested and injected. The 
veins of the head and neck are distended 
during the paroxysms and the face becomes 
" cyanotic " or blue. Vomiting occurs dur- 
ing the coughing spells, and sometimes 
bleeding at the nose. After a prolonged 
spasm or paroxysm the characteristic 
" whoop " appears. 

This stage lasts from two to four weeks, 
and occasionally longer, finally running into 
the third, or improvement, stage. 

Improvement Stage: The disease is now 
declining in severity and the symptoms 



CHILDHOOD DISEASES 101 

gradually disappear. The paroxysms be- 
come milder and less frequent, and event- 
ually cease. This stage lasts for about two 
to three weeks. The patient is left in a 
pronounced angemic and nervous condition, 
and at times is completely prostrated. 

Treatment: Unfortunately, no cure has 
yet been found. The disease must run its 
course. I do not know of any medicine 
which will be of the slightest benefit. 

Keep the child in the open air and pro- 
tect it from extreme temperature changes 
by proper clothing. Expectorant remedies, 
or cough syrups, and all patent medicines 
are totally valueless. Local applications 
and spraying give no relief. 

The patient should be quarantined. For 
the rest, care and patience must be exer- 
cised while the disease runs its own course. 
Nothing else can be done. 



VIII 

NERVOUS DISEASES OF CHILDHOOD 

THERE are certain diseases of the 
nervous system which creep insidi- 
ously upon a little one, and, unless 
parents are constantly watching their chil- 
dren, these disorders will make headway 
without being noticed or checked. Many 
of the nervous symptoms, even at the very 
beginning of some trouble, are so pro- 
nounced that it seems incredible that par- 
ents do not at once become alarmed. Take, 
for instance, the nervous twitchings of St. 
Vitus's Dance, or the hesitancy of speech 
in the beginning of a stammer; there is 
strange ignorance or strange carelessness 
on the part of parents who do not notice 
that such abnormalities are certainly not 
characteristic of normal children. Fortu- 
nately, the old days of indifference are 
passing away, though in a somewhat lei- 
surely manner — far too leisurely, indeed, 
for the happiness of the individual home 



NERVOUS DISEASES 103 

and the welfare of the nation. But there 
is undoubtedly a higher standard now than 
formerly. Each year, more men and 
women who undertake the responsibilities 
of marriage are trying to fulfil those re- 
sponsibilities, in some measure, at least, 
with regard to their children. 

The nervous system of a child is ex- 
tremely complex. But certain fundamental 
symptoms, such as twitching and nervous 
movements or nervous articulation, have 
perfectly clear meanings, and it is not 
necessary to be a physician in order to rec- 
ognize them. Of course, I cannot give a 
complete scientific consideration of the sub- 
ject in this volume; but I will point out 
some of the danger signals and explain as 
simply as possible the common symptoms 
of the common disorders. 

A child's nervous system is as undevel- 
oped and imperfect as its body. Just as 
the muscular system makes gradual prog- 
ress until it is adjusted to its complete 
functions and can withstand the strain of 
normal life, so the nervous system has to 
grow and adapt itself for duties that would 
crush it if imposed prematurely. 



104 MOTHER AND CHILD 

The brain of a child is immature and 
unstable, readily susceptible to wrong im- 
pressions and functional disturbances. The 
general proneness to irritability, twitchings, 
spasms, fits, emotional excitement, tempers 
and moods illustrates the imperfect state 
of health that permeates the higher nerve 
centres. Neurotic children are sick chil- 
dren. It is no good dismissing the matter 
with a careless : " Oh, he 's a little nervous, 
but he will soon be all right if you leave 
him alone." Nervous children must not be 
" left alone." On the contrary, great care 
and watchfulness must be exercised until 
every trace of a neurotic tendency has 
disappeared. Encouragement is of great 
value, and patience with these little ones 
is more than a virtue. 

Dr. John Thompson of Edinburgh re- 
cently issued at his clinic some sound 
suggestions : 

" The mother must recognize and admit 
that her child is mentally defective, and be 
ready to co-operate with the teacher and 
the doctor in its special treatment. With- 
out this triple co-operation little permanent 
good can be effected, and parental indiff er- 



NERVOUS DISEASES 105 

ence in the home can undo much good ac- 
complished by expert tuition in the special 
schools. Teach the child to respect himself, 
and make him recognize that he hves under 
natural laws to which he must conform. 
Moral defects require firm discipline com- 
bined with kindness and tact. Cultivate the 
child's moral sense of right and wrong; 
encourage him to exercise self-control; ex- 
plain to him that concentration of energy 
is necessary for him to earn his living as a 
man. Try to make him even vain in his 
good qualities, and to take a pride in his 
superiority to weaknesses. Train him to be 
something; provide him with an objective; 
with an ideal — that he may learn to be- 
have as a grown-up man. Find him a suit- 
able occupation. A clumsy fingered child 
may make a gardener; a child with neat 
fingers a bookbinder or wood-worker. 

" Extol the beauty of the humblest work 
— teach him never to despise labor of any 
kind, for the child may be unfitted for any- 
thing but menial tasks. If a girl is defec- 
tive, teach her that every woman takes a 
pride in housework, and that to set a table 
well is an act of distinction. The individu- 



106 MOTHER AND CHILD 

ality of a child must be kept sacred, and 
the production of the state of mental equi- 
librium — ideal sanity — be regarded as the 
goal in educational methods." 

The following common nervous diseases 
should be studied, and if a child exhibits 
the symptoms of any of these disorders, a 
neurologist should at once be consulted: 

HYSTERIA 
NEURASTHENIA 

NIGHT TERRORS (Pavor Noctumus) 
ST. viTUs's DANCE (Chorca) 

STAMMERING 

NERYOUSNESS: MELANCHOLY: MENTAL 
FATIGUE 

Hysteria 

It is almost impossible to define Hysteria. 
There are so many queer symptoms that it 
can only be described as a disease of the 
nervous system characterized by a variety 
of manifestations. It is closely allied with 
Neurasthenia, and frequently the two are 
seen together. » 

Cause: Children who are underfed, anse- 
mic, of neurotic parentage or neurotic 



NERVOUS DISEASES 107 

disposition are especially liable. Heredity 
plays a very important part. " Brain 
storm " children, or children whose brain 
centres are unduly excitable or active, are 
always possible victims. Females are par- 
ticularly susceptible. 

Symptoms: Various as the manifesta- 
tions are, the symptoms of Hysteria are 
always peculiarly characteristic and easily 
recognized. Screaming and sobbing are 
common. A very common symptom is the 
so-called " Globus Hystericus," a feeling 
as if a lump were in the throat which can- 
not be swallowed but impedes the breath- 
ing. There is lack of will power; high 
excitability; ungovernable nervous temper- 
ament. The child may have a fit, spasm 
or convulsion, which may seem like a true 
spasm of epilepsy to the family, but a phy- 
sician will recognize the difference imme- 
diately. Usually when the patients go into 
these false spasms or fits, they select the 
most comfortable place in the house for 
the attack. The lounge or bed is quite soft 
and easy to fall upon and the hysterical 
child fully recognizes the fact, for almost 
invariably the physician finds the patients. 



108 MOTHER AND CHILD 

after hysterical fits or convulsions, unhurt 
in every particular. 

Treatment: It should be remembered 
that any case of Hysteria, no matter how 
alarming, may recover completely in a very 
short time. If possible, eliminate the cause 
of the difficulty. Tonic treatment and a 
well nourishing diet together with a change 
of surroundings will be found decidedly 
beneficial. 

The family should at all times be patient 
with such cases and try to inspire confidence 
and encourage the development of self- 
control. Firmness and kindness with a 
large amount of encouragement are abso- 
lutely necessary for the success of the treat- 
ment and the restoration of perfect health. 

If Hysteria is actually complicated by 
some organic trouble, special care by a phy- 
sician is demanded. 

Neurasthenia 

This is a disease of the nervous system, 
as nervous debility or nervous prostration. 

Causes: Neurotic children are very sus- 
ceptible, especially those with hereditary 



NERVOUS DISEASES 109 

nervous tendency. Prolonged mental ex- 
citement; overwork at school; mental and 
physical exhaustion; sexual excesses; eye- 
strain from uncorrected refractive errors. 

Symptoms: Headaches; depressed spirits; 
inability to study or to concentrate upon 
one thing ; dizziness ; indisposition ; general 
muscular weakness, the child being tired 
most of the time; pains in limbs and the 
back of the head; weakness of extremities; 
gastric disturbances with coated tongue and 
constipation; imaginary heart troubles and 
palpitation. The hands and feet are gen- 
erally cold. 

Treatment: Remove the cause of the dis- 
ease. Moral treatment is of great impor- 
tance, and sympathy and comprehension 
have cured many a case. The patient should 
be assured that he is not seriously ill. He 
should be taken from school and all study 
should be stopped. Where inactivity has 
been the rule, regular physical exercise in 
moderation should be secured. Children 
who are pale or anasmic and weak will re- 
quire the " rest cure," or the " S. Weir 
Mitchell " treatment. 

The " Weir Mitchell " treatment invari- 



110 MOTHER AND CHILD 

ably gives brilliant results. It consists of 
absolute rest in bed, forced feeding with 
the most nourishing foods, and the employ- 
ment of electricity and massage. 

Tonics of all kinds are valuable — iron, 
quinine, arsenic, phosphorus and strychnine 
in some form are the most satisfactory. 

Change of air is beneficial. A diet con- 
sisting of rich soups, puddings, eggs, milk 
and cream should be given. 

Eyestrain — a frequent cause of disorders 
— should be corrected. 

Night Terrors 
[Pavor Nocturnus] 

This condition is one of nervousness, 
found generally in the neurotic child who, 
during sleep, will suddenly awaken terri- 
fied. This period of terror lasts from a few 
minutes to half an hour, during which the 
child will see visions. It is difficult to com- 
fort the child at the time, but it will usu- 
ally fall asleep again after a short time and 
will have natural rest for the balance of 
the night. 

Night terrors are rarely seen in children 



NERVOUS DISEASES 111 

with sound bodies and healthy minds. The 
" dime novel," " Nick Carter " type of boy 
or the over-studious nervous girl is fre- 
quently troubled. 

Treatment: There is no specific remedy. 
Tone up the nervous system and do not 
allow naturally studious children to work 
too hard. See that no unsuitable books are 
read. Eyestrain should be corrected. A 
good cathartic and a careful diet will be 
highly beneficial. If it be possible definitely 
to determine the cause of the trouble, use 
pains to remove it. The real cause may be 
apparently quite insignificant. 



St. Vitus's Dance 
[Chorea] 

This is a nervous affection generally found 
in girls, but sometimes also in boys rang- 
ing from six to nine years of age. 

There is invariably on the part of the 
patient a nervous predisposition and tem- 
perament, and a family history of insanity, 
epilepsy and hysteria is not uncommon. 

Symptoms: The symptoms of this dis- 



m MOTHER AND CHILD 

ease are unmistakable — inattentiveness, 
clumsiness, quarrelsomeness, irritability, ex- 
citability and forgetfulness are the predom- 
inating signs, accompanied by a charac- 
teristic twitching. The child does not keep 
still; it is fidgety, constantly raising its 
shoulders; twisting about and jerking its 
head. The muscles of the face become in- 
volved and the most grotesque countenances 
are produced. The stammering child is 
invariably found in this type of nervous 
trouble. The general health is of course 
below normal, and the child is pale and 
anaemic. 

Treatment: The child must at once be 
taken out of school and given absolute rest, 
preferably in bed. Hygienic conditions and 
surroundings must be improved. If the 
family can afford it, a change of climate is 
beneficial. Stop everything that tends to 
excitement. Correct eyestrain and defects 
of speech, and place the child on a tonic 
treatment. Remedies such as arsenic and 
iron are valuable. Occasionally other reme- 
dies are necessary, and the family physician 
should be consulted and trusted. Care 
should be given to the diet and a highly 



NERVOUS DISEASES 113 

nutritious one should be adopted if the pa- 
tient can tolerate it. 

Occasionally inflammation of the heart is 
found in this disease, and it is therefore 
essential that the patient be examined 
frequently. 

The disease is not incurable. It some- 
times lasts as long as three months, but with 
proper care and treatment the course can 
be curtailed. 

Stammering 

Stammering is a nervous affection of 
speech characterized by faulty articulation. 

Causes: These apparently are few. (1) 
Spasm of respiratory muscles while trying 
to speak. (2) Deficient harmony between 
mechanism of vocalization and of articu- 
lation. (3) Naso-pharyngeal affection — 
chiefly adenoids. 

Before treatment is undertaken, it is ne- 
cessary to understand thoroughly the me- 
chanical trouble which is causing the defect. 
The average practitioner of medicine is not 
capable of treating this disease. He has 
not the time, as a general rule, and, fur- 
ther, he does not, probably, understand the 



114 MOTHER AND CHILD 

principles upon which the treatment is 
based. There are speciaHsts who devote 
their entire time to this disorder, and they 
are the proper advisers to whom to go for 
treatment. Dr. E. W. Scripture of New 
York, and Mrs. Emily Behnke, Earl's 
Court, London, England, have done much 
work in this connection, and both are en- 
tirely capable. 

Parents should realize that while most 
cases are curable, the improvement in many 
cases is slow, and years are required to ef- 
fect a complete cure. 

Again, parents should realize that the 
misery caused to children by this disorder 
is very great: their dispositions may be 
changed and their future careers ruined 
unless treatment be undertaken as soon as 
possible and continued patiently. 

Treatment: 1. Children who stammer 
should be isolated — stammering is 
contagious. 

2. All obstructions to nasal breathing 

should be removed. 

3. Breathing exercises are important, 

and the patient should be taught 



NERVOUS DISEASES 115 

to inflate and deflate the lungs 
very slowly, breathing through the 
nostrils. 

4. The patient must be taught to read 

slowly, articulating carefully and 
distinctly. 

5. Musical tone reading with the pitch 

of the voice raised and lowered is 
beneficial. 

6. Select the sounds which give diffi- 

culty, and practise words and sen- 
tences containing them. 

7. Parents should always speak slowly 

and distinctly to stammering chil- 
dren, and never allow the children 
to lapse into a careless way of 
speaking, otherwise the cure is 
retarded. 

8. Do not allow stammering children to 

attend public schools. 

9. Correct as soon as possible any other 

nervous affection associated with 
stammering, such as St. Vitus's 
Dance, etc. 

10. Give tonic treatment, rest, fresh air. 

11. Circumcision is not beneficial in this 

disorder. 



116 MOTHER AND CHILD 

Nervousness: Melancholy: Mental 
Fatigue 

These are general indications of an ab- 
normal nervous condition, and demand 
watchfulness and comprehension. See that 
no specific disorder is threatened, and, if 
not, apply the general principles for deal- 
ing with neurasthenia — rest, a simple 
nourishing diet, the removal of worry and 
excitement, fresh air, moderate exercise, 
and, especially, the sense of confidence be- 
tween parent and child without which the 
latter cannot develop normally, or be saved 
from the big and little pitfalls that are 
waiting for him both during childhood and 
in later years. 



IX 

MINOR DISORDERS OF CHILDHOOD 

A CHAPTER upon diseases not par- 
ticularly dangerous, and yet quite 
common, seems imperative, as such 
disorders are usually reserved entirely for 
home treatment, a physician not being called 
in unless the case proves unexpectedly 
severe. A little definite knowledge is there- 
fore very desirable, for some curious super- 
stitions and stupid practices still survive, 
and many a child suffers from this crude or 
experimental home treatment. 

Here is a little list of common, but rarely 
complex, disorders : 

BOILS 

EARACHE 

HEAD LICE 

HIVES 

NEURALGIA 

NOSE BLEED 

POISON IVY OR OAK RASH 



118 MOTHER AND CHILD 

prickly heat 
eingworm 
thrush or sprue 

Boils 
[Furunculosis] 

A boil or furuncle is a small purulent 
tumor situated in the skin. It is caused by 
an infection due to a pus germ which finds 
entrance through the hair follicles of the 
skin. These small germs settle in the deeper 
layers of the skin and under the skin, and 
set up an acute inflammation. Children 
and adults in poor health are susceptible. 

Symptoms: These can rarely be mis- 
taken. At first there is a slight itching at 
the point where the infection is carried 
through the skin, and within twenty- four 
hours afterwards there is probably a small 
pimple or red raised area, which is decidedly 
irritable. Induration or swelHng becomes 
pronounced, and later an annoying, pulsa- 
ting, throbbing, aching pain becomes the 
characteristic symptom, with much swelling. 
Sometimes the disease is so severe that con- 
stitutional symptoms are noticed. Loss of 



MINOR DISORDERS 119 

appetite and sleep, constipation, nervous- 
ness and nervous headache are common. 

Treatment: Operative treatment alone is 
worth consideration as a means of ending 
the disease quickly. There is such general 
aversion, however, to the use of the knife 
that remedial measures must be mentioned. 

Never squeeze a boil. Tissues which are 
badly indurated are best left alone instead 
of being still further irritated. The idea 
that the " core " can be squeezed entirely 
out of a boil is utterly wrong. Some of the 
pus and degenerated matter will, of course, 
come away when pressure is used, but in- 
fected matter invariably remains, and the 
only important result is a good deal of pain 
to the patient, and a good deal of damage 
to the tissues. 

Poultices of linseed or flaxseed should 
not be used, as they are essentially dirty and 
have no desirable result. Soap and sugar, 
or the white of an Qgg^ should not be placed 
upon a boil to " draw " it. 

Hot wet dressings will relieve the pain 
and end the trouble more quickly than any 
other medication. But a more modern and 
less painful treatment is the following : 



UO MOTHER AND CHILD 

A half-teaspoonful of carbolic acid to a 
quart of hot water. Soak some sterile plain 
white gauze in the solution. Partly wring 
the gauze out and apply it loosely to the 
boil, covering it with a small amount of 
rubber tissue and bandage. The dressing 
should be kept wet and changed twice daily. 

Bichloride of mercury solution is just as 
efficacious and should be used in the same 
way. Small bottles of bichloride tablets can 
be purchased at any drug store. One-quar- 
ter of a tablet dissolved in a quart of hot 
water will answer the purpose. 

A hot saturated solution of boracic acid is 
also beneficial. 

The use of any antiseptic wet dressing 
with sterile gauze is far better and cleaner 
than a poultice. While the action is prac- 
tically the same, the medicated solution has 
a tendency to soak into the skin and kill 
whatever germs are on the surface of the 
skin. The poultice, on the contrary, has no 
antiseptic properties and is simply a means 
of keeping the pus germs alive and giving 
them nourishment, for there are miUions of 
germs developing upon the surface of a hot, 
dirty poultice. 



MINOR DISORDERS 121 

If such treatment be kept up for a few 
days, rigorously, the boil will soften, the 
pain will disappear, and soon the so-called 
" core " will come out. 

The quickest and best method of treat- 
ment, however, is certainly a free incision 
into the boil and a thorough scraping away 
of all debris or degenerated tissue, draining 
the boil and applying a large antiseptic wet 
dressing. 

If the disease be persistent, tonic treat- 
ment internally, rest and an appropriate 
diet should be given. Children's bowels 
should be kept freely open by the adminis- 
tering of salts. 

Earache 

Earache is not a disease, but a symptom 
of acute catarrh of the middle ear. This is 
quite a common affection due to exposure to 
cold and wet, and especially cold in the head. 
Catarrh of the ear occasionally follows scar- 
let fever, pneumonia, measles, nasal douch- 
ing, entrance of water through the Eusta- 
chian tube. Earache also follows the accu- 
mulation of wax which has become hardened 
in the ear. 



122 MOTHER AND CHILD 

Symptoms: Sense of fulness of the ears; 
pain (earache) ; shght loss of hearing; 
buzzing in the ears; redness, swelling and 
bulging of the ear drum. 

Treatment: On account of the sensitive- 
ness of this organ it is obligatory that the 
parents consult an ear specialist as soon as 
possible. Pain in the ear can be temporarily- 
helped, especially if it is due to hardened 
wax, by very warm water douching. A pint 
or more of sterile water as hot as possible 
should be allowed to run into the ear with 
not too much force every hour until a phy- 
sician's services can be obtained. Putting 
hot oil, blowing tobacco smoke into the ear, 
or poulticing is a dangerous procedure and 
none of these should ever be attempted. The 
condition " earache " and especially the 
cause of it should only be treated by a skilled 
physician who thoroughly understands ear 
treatment. 

Head Lice 

[Pediculosis Capitis] 

Pediculosis Capitis is an inflammation of 
the skin and scalp caused by head lice. 



MINOR DISORDERS 123 

These lice are generally found upon the 
heads of children of the poorer classes and 
are communicated by direct contact only. 
While there are several varieties of the dis- 
ease, it is only necessary to refer to the 
common one. 

Symptoms: There is profound itching 
and inflammation of the scalp and lower 
part of the neck. Often the infection of the 
skin, due chiefly to scratching, causes large 
lumps to appear on the back of the neck. 
These lumps are infected glands, and are 
really dangerous. 

Treatment: To remove the nits use tinc- 
ture cocculus-indicus, diluted well with 
water, the head being first washed thor- 
oughly with hot water and soap — prefer- 
ably naphtha soap. The nits may also be 
removed by using hot vinegar and a fine 
tooth comb. An excellent remedy for this 
condition is to wash the hair thoroughly 
with kerosene and allow it to remain wet for 
some hours. In this, however, there is dan- 
ger should the patient get near a flame, and 
great care must therefore be exercised if 
this remedy is tried. 

The skin disease and slight glandular en- 



124 MOTHER AND CHILD 

largement which often accompany this 
trouble require no special treatment. A 
mild ointment such as zinc oxide is all that 
is necessary. 

Hives 
[Urticaria] 

The definite cause of this disease is not 
known. It is generally attributed to in- 
discreet feeding, indigestion, or certain ar- 
ticles of diet. Strawberries and shellfish 
and the bite of certain insects have produced 
the disease. 

It is one of the most aggravating and 
annoying of the skin disorders. It appears 
rather quickly in the form of numerous 
papules or wheals. This pale eruption of 
papules lasts for a short time, when a new 
crop will appear elsewhere — hands, feet 
and body will probably suffer. The char- 
acteristic symptom is the intense smarting, 
burning, itching sensation as the eruption 
appears. 

Treatment: Prevent scratching and sub- 
sequent infection of the skin by seeing that 
the child wears mittens. Epsom salts, 



MINOR DISORDERS 125 

calomel or a castor oil purge should be ad- 
ministered immediately. Rest in bed on a 
diluted milk diet is beneficial. 

Local treatment serves to allay the itch- 
ing and is beneficial. Hot salt or bicar- 
bonate of soda bath — boric acid wet dress- 
ings — equal parts of alcohol and water — 
weak carbolic acid solution (a teaspoonful 
to two quarts of water). 

Internally, when rest is impossible, give 
a sleeping powder. 

Although the disease is in no way danger- 
ous and a cure is inevitably the rule, some 
cases recur with great persistence. 

INTeuiialgia 

Neuralgia is a condition due to inflamma- 
tion of the nerves, in which pain is the pro- 
nounced symptom. 

There are various kinds, but the most fre- 
quent is neuralgia of the face. 

Causes: 1. Exposure to the cold and 
wet. 

2. Injury to nerves. 

3. Extension of inflammation from 

mouth. 



126 MOTHER AND CHILD 

4. Toothache. 

5. Infections from teeth. 

6. Follows acute infections and conta- 

gious diseases and ptomaine poi- 
soning. 

Symptoms: 1. Constitutional symp- 
toms, at times severe. 

2. Gastric disturbances frequent. Appe- 

tite lost. 

3. Nervous condition develops. 

4. Rest and sleep at times are impossible. 

5. Severe headaches are common. 

6. Constipation is the rule. 

7. Pain is generally located on one side 

of the face and is a continuous 
annoying aching sensation. Pain is 
generally a little worse at night. 
For several days the pain increases 
in severity unless treatment is ap- 
plied. Slight swelling of the face 
generally follows the pain which 
disappears as soon as the inflamma- 
tory condition of the nerves subsides. 

Treatment: Treatment must be vigor- 
ously kept up. 

1. Remove the cause if possible. 



MINOR DISORDERS 127 

2. If due to teeth conditions, consult a 

dentist. 

3. Hot applications to the parts — in 

the form of hot water bottle, hot 
flannels, hot wet dressings — are at 
times beneficial and relieve suffering 
considerably. 

4. Free saline cathartics are advisable. 

A dose of Epsom salts or a glass 
of Citrate of Magnesia should be 
given every rnorning. The dose, of 
course, must be regulated according 
to the age of the patient. 

5. Medicine to relieve pain is necessary 

and should be given with care. 
Opiates are the only remedies which 
temporarily relieve this condition 
and assist in curing. 

6. Local application of medicines are at 

times beneficial and give great re- 
lief — Baume Analgesique Bengue 
and Capsicum Vaseline have been 
applied with some success. Either 
of these medicines may be used in 
the following manner : 

Spread freely over the part where 
the pain is felt and rub in well, 



128 MOTHER AND CHILD 

covering the application afterward 
with a piece of musMn or flannel. 

Mustard plasters and tincture of 
iodine are a great help as counter 
irritants, but are too severe upon 
the skin for the amount of benefit 
derived. 

Nose Bleed 

[Epistaxis] 

Nose bleed occurs under the following 
conditions : 

1. Inflammatory or congested condition 

of the mucous membrane of the 
nose. 

2. Injury to nose. 

3. Blood diseases and infectious fevers. 

4. Heart and lung diseases. 

5. Beginning of fevers, especially Ty- 

phoid and Scarlet Fever. 

6. Blowing the nose violently. 

7. Family heredity. 

8. Occasionally it occurs without any 

apparent cause. 

Treatment: Numerous nose bleeds should 
be a warning and the case seen by a physi- 



MINOR DISORDERS 129 

cian, preferably a nose specialist. When 
hemorrhage is severe, a physician is neces- 
sary. 

Mild cases should be treated by the fol- 
lowing methods: 

1. Absolute rest is essential. 

2. Do not rub, wipe, or blow the nose. 

3. Close the nostrils and allow a clot to 

form; bleeding generally stops. 

4. Plug the nostrils with absorbent 

cotton. 

5. Hold ice water cloths over nose. 

If these simple methods are not success- 
ful, call a physician inmiediately. 

Poison Ivy or Oak Rash 
- [Dermatitis Venenata] 

An eruptive disease caused by contact 
with Poison Ivy (Rhus Toxicodendron), 
Poison Oak (Rhus Diversiloba) or Poison 
Sumac (Rhus Venenata). 

Symptoms: These generally appear in 
the form of minute papules and vesicles. 
Intense burning and itching are present. 
The hands and face may swell considerably 



130 MOTHER AND CHILD 

and, associated with constitutional symp- 
toms, may give rise to much discomfort. 

The disease is entirely curable, but sen- 
sitive patients may have a recurrence year 
after year. It is well to avoid at all times 
close proximity to the plants causing the 
trouble. 

Treatment: This is not always simple, as 
the disease seems to grow temporarily worse 
under treatment. Severe continued treat- 
ment in neurotic patients seems almost 
unendurable. 

The bowels should be well moved and a 
milk diet is preferable. 

Local application of the following will be 
beneficial : 

Alcohol and water, equal parts. 

Lotion of Sulphate of Zinc — 10 grains to 
one pint of water. 

Fluid Extract Grindelia Robusta diluted 
with water — one part Grindelia to four 
parts water. 

Sweet Spirits of Nitre slightly diluted 
with water. 

Lead and Opiima wash. 

Ichthyol ointment or Zinc Oxide oint- 
ment. 



MINOR DISORDERS 131 

Whatever treatment is adopted must be 
continued persistently. 



Prickly Heat 
[Miliaria] 

This is an acute disease of the sweat 
glands in which are seen very small red 
papules and vesicles, accompanied by 
itching. 

Causes: Over-heating (a frequent cause) ; 
too much clothing; hot weather; fevers. 

Symptoms: There are found on the trunk 
small red vesicles and papules which burn, 
itch or cause a pricking sensation, frequently 
associated with free perspiration. 

Treatment: This should be directed to 
getting the bodily temperature normal. A 
saline cathartic is beneficial, viz., Epsom or 
Rochelle salts. A restricted diet for a few 
days on milk and broth should be given. 
Application to the skin of a mild solution 
of carbolic acid (a half teaspoonful to a 
quart of water) or boric acid solution is 
helpful. A bland dusting powder liberally 
applied gives relief. 



132 MOTHER AND CHILD 

Ringworm 
[Tinea Tonsurans] 

Ringworm of the scalp is observed chiefly 
in children. 

Symptoms: There will be seen one or 
more round, scaly patches with a slightly 
raised dirty gray colored surface in which 
dry broken hair penetrates. The patches 
are sometimes quite numerous. 

Treatment: Wash the scalp thoroughly 
with naphtha soap and hot water. Pull out 
all infected dry hair. Ointments of sulphur 
and mercury will be found beneficial and 
should be applied daily. Painting the 
patches with tincture of iodine until they 
are entirely black will be found helpful. 
Repeat the painting every two days if neces- 
sary. A night cap for the scalp should be 
worn, so that the treatment may be un- 
interrupted. 

Thrush or Sprue 

This is a parasitic disease, which appears 
first in the form of small white pinhead 
spots on the inner surfaces of the cheeks 



MINOR DISORDERS 133 

and on the tongue. The disease is seen 
chiefly in nurshngs and in those children 
whose health is debilitated. Weak, maras- 
mic, bottle-fed babies are especially sus- 
ceptible. 

Children with the disease often suffer 
considerable pain and discomfort while nurs- 
ing. Gastro-intestinal trouble is frequently 
present, and also diarrhoea and vomiting. 

Treatment: Medication is of no benefit, 
with the possible exception of small doses of 
bicarbonate of soda given twice daily. The 
effective treatment consists in paying par- 
ticular attention to the hygiene of the child's 
nursing. Rubber nipples should be thor- 
oughly boiled and the mother's nipples ster- 
ilized as thoroughly as possible with a solu- 
tion of boracic acid; or, better still, draw 
the milk out with a breast pump and feed 
the child with a spoon. The child's mouth 
should be wiped out very carefully, before 
and after feeding, with a piece of soft cotton 
wound around the little finger and soaked 
in saturated boracic acid solution. The 
bowels of the infant should be kept open 
with castor oil. 



X 

SOME SIMPLE OPERATIONS 

IT would be out of place here to discuss 
surgical cases generally. But a few 
words with regard to simple wounds 
and lacerations will be useful; and as so 
many children have tonsils or adenoids re- 
moved, or should have them removed, a short 
section on the subject has been added, with 
some necessary advice with regard to the 
administration of anaesthetics. Appendi- 
citis, also, has been so prevalent that it re- 
quires consideration. 

Hemorrhage 

There are two kinds of hemorrhage result- 
ing from cuts — venous hemorrhage and 
arterial hemorrhage. 

Venous hemorrhage is marked by the con- 
tinuous flow of dark red blood, and arterial 
hemorrhage by the intermittent spurting of 
bright red blood. 



SIMPLE OPERATIONS 135 

Lacerations of tissues, if at all severe, 
with considerable bleeding, should be treated 
by a physician or surgeon, as stitches may 
be necessary to draw the surfaces of a cut 
wound together in order to stop hemorrhage 
and secure a better cosmetic result. But 
many simple cases can be treated by a 
parent. 

Hemorrhage may be stopped by 

1. Pressure — Use a clean handkerchief, 

or sterile gauze, if possible. Apply 
over the cut and hold tightly for 
some time until the bleeding stops. 
If the bleeding is severe, hold gauze 
in place or bandage until the sur- 
geon arrives. 

2. Hot Water — Use a handkerchief or 

sterile gauze wrung out in very hot 
water; apply to the cut surface, 
continuing to change the gauze as 
soon as heat begins to leave it. The 
heat coagulates the blood and hem- 
orrhage invariably stops. 

3. Cold or Ice apphcations can be used 

in the same way, but they are not 
so effective. 

4. Medicines, such as tincture of iron, 



136 MOTHER AND CHILD 

tannic acid, adrenalin, alum, can be 
applied effectively. 
5. Tourniquet — The application of a 
constrictor placed around a part 
sufficiently tightly to stop bleeding. 
When such a method is used, the 
hemorrhage, of course, is severe and 
a surgeon's services are imperative 
inmiediately. 

After all hemorrhage has been stopped, 
the after treatment of the case remains im- 
portant. No matter what the condition — 
an abrasion, a cut, a punctured, contused 
or lacerated wound — the question of clean- 
liness is the first consideration after the flow 
of blood has been stopped. Soap and water 
play the leading role, and it should be re- 
membered that the use of too much of both 
is an impossibility. After thoroughly wash- 
ing the parts, a detergent such as peroxide 
of hydrogen or dioxygen should be used. 
I thoroughly approve of peroxide. It can 
certainly do no harm, and is invariably 
beneficial. 

After the washing and cleansing, I always 
use either a saturated solution of boracic 
acid, or a solution of carbohc acid, very 



SIMPLE OPERATIONS 137 

mild. If the part to be treated is near the 
eyes or mouth, I use boric or boracic acid 
solution; if elsewhere, carbolic acid solu- 
tion. The boracic acid solution should be 
made in the following manner: Dissolve as 
much boric acid in a pint or quart of hot 
water as it is possible to dissolve, making 
what is known as a " saturated " solution. 
The carbolic acid solution is not made 
stronger than a half teaspoonful of carbolic 
acid to a quart of water. Lysol is another 
well-known remedy, used as carbolic, in the 
same proportions. 

When solutions are prepared, sterile 
gauze or clean Hnen or handkerchiefs or 
bandages should be wrung out in the solu- 
tion and applied quite damp to the part to 
be treated. 

The dressing should now be bandaged and 
not changed for twelve hours. But it should 
be kept fairly wet all the time. 

A wound treated by continuous wet dress- 
ings, as just described, is a very hard wound 
to infect; and if already infected will yield 
as a rule very quickly to treatment. 



138 MOTHER AND CHILD 

Tonsils and Adenoids 

A good deal of attention has been given 
to the subject of Tonsils and Adenoids dur- 
ing the last few years. Formerly, tonsils 
were treated and " doctored," and adenoids 
were neglected. To-day, thanks to the 
progress of scientific nose and throat work, 
both are treated as they should be, and are 
removed. 

Tonsils are useless, and if enlarged are 
a menace to health. Continued inflamma- 
tion of the tonsils tends gradually to destroy 
these glands, and during the process of de- 
generation, infection is very liable to enter 
through the tonsils and be transmitted to 
the glands of the neck. Tubercular glands 
of the neck are invariably caused in this way, 
by infection entering the tonsils and then 
the glands. 

Any child with sore throat and swollen 
tonsillar glands should be taken to a surgeon 
and have the tonsils removed. 

Adenoids are tissues formed at the back 
of the nose; they are useless, and danger- 
ous. This tissue mass degenerates and pre- 
vents the child from breathing properly. 



SIMPLE OPERATIONS 139 

The child becomes ill and stupid, and the 
results may be very serious unless the con- 
dition receives surgical care. 

A surgical operation is the only cure both 
for enlarged tonsils and for adenoids. 

The removal of tonsils and adenoids does 
not alter the child's voice, nor is it harmful 
in any way. It is only, and always, bene- 
ficial to the child's health. The operation 
itself need not be dreaded. The normal 
child recovers very quickly, and shows 
marked improvement in general health and 
mental brightness. 

Anesthesia 

There are numerous ansesthetics — ether, 
chloroform, laughing gas, the injection of 
cocaine locally and injections into the spinal 
column. I prefer ether anaesthesia because 
it is safer than any of the others, and entirely 
satisfactory. There are cases, however, in 
which other methods must be used ; but they 
are rare. 

In taking ansesthesia, follow these rules : 

1. Always have it administered by an 
expert. 



140 MOTHER AND CHILD 

2. Insist upon using ether whenever 

possible. 

3. Eat nothing for twelve hours before 

taking it. 

4. See that the bowels are thoroughly 

empty. 

5. Remove all false teeth: deaths have 

been caused by swallowing them. 

6. Be sure to ask the doctor if the heart 

action is normal. The specialist 
will always examine the heart — 
the " matter-of-fact " doctor occa- 
sionally neglects to do so. 

7. Complete rest, alone, for one hour 

before anaesthesia is advisable. 
Any excitement should be avoided. 

8. See that the room where the anaes- 

thetic is given and the patient 
operated upon is warm. 

9. Patients coming out of anaesthesia 

should be protected from cold and 
draught. See that the nurse is pro- 
vided with blankets to protect the 
patient. 
10. Realize that fatalities due to ether 
are extremely rare, and take it 
without fear and with absolute 
confidence. 



SIMPLE OPERATIONS 141 

Appendicitis 

Appendicitis is an inflammation of the so- 
called Vermiform Appendix. 

Causes: 1. Foreign bodies getting into 
the appendix (uncommon). 

2. Local injuries. 

3. Indiscretions in diet. 

4. Constipation. 

5. General systemic infection following 

tuberculosis, syphilis, and acute in- 
fectious diseases. 

6. Following inflammation of the intes- 

tines — especially the colon. 

7. Susceptibility after a previous attack 

of appendicitis. 

Symptoms: Constitutional symptoms are 
generally pronounced — high fever, rapid 
pulse and constipation are invariably asso- 
ciated with an attack. 

The temperature ranges from 100 to 103, 
and the pulse runs as high as 130. 

The general appearance of the patient is 
changed. There is anxiety, irritability and 
restlessness. 

Pain in the lower right part of the abdo- 
men is the pronounced symptom, and de- 



142 MOTHER AND CHILD 

velops rapidly. There are varying degrees 
of pain, however. Occasionally, only ten- 
derness appears over part of the abdomen. 
Or there may be sharp lancinating definite 
pain on the right side of the abdomen — 
about 214' below and 3'' to the right of the 
mnbilicus. This is more common, and very 
indicative. Associated with this pain, there 
is considerable rigidity of the right abdomi- 
nal muscles. The muscle wall hardens. The 
patient frequently flexes the right leg to re- 
lieve the tension of the abdomen and ease 
the pain. 

Patients with the foregoing symptoms 
and the pathognomonic or decisive signs, a 
flexed leg and a rigid abdomen, unquestion- 
ably have appendicitis. 

Treatment: Medical treatment in many 
cases is temporarily beneficial, although ap- 
pendicitis is essentially a surgical disease, 
and a surgical operation is the only method 
by which an absolute cure is effected. The 
operation is not severe, and when it is per- 
formed by a good surgeon, the danger is 
slight. 

Medical Treatment: Keep the patient in 
bed. Give liquid diet. Place an ice bag 



SIMPLE OPERATIONS 143 

over the right side of the abdomen. Give 
a high enema. Do not give cathartics. 
Medicine to reheve pain is sometimes neces- 
sary, although it is dangerous to give it, 
since it masks symptoms and the true course 
of the disease is not seen. Call a physician 
or surgeon immediately. 

Appendicitis is occasionally confused with 
the following diseases : 

1. Liver colic. 

2. Intestinal colic. 

3. Kidney colic. 

4. Typhoid fever. 

5. Hysteria. 

6. Movable kidney. 

Appendicitis, at any moment, may be 
considered a grave disease, and the services 
of a surgeon are absolutely necessary. 



XI 

EUGENICS 

ANY modern book dealing with the 
subject of children would be incom- 
plete if it did not contain a chapter 
on Eugenics. 

Eugenics comprises the study of every 
factor bearing on the welfare of the race — 
physical, mental and moral. It is consid- 
ered under the two heads of Positive and 
Negative Eugenics. Positive Eugenics 
studies the influences of heredity, environ- 
ment and education. Negative Eugenics 
gives attention to what are called the social 
poisons — agents which cause deterioration 
— without reference to heredity. The most 
important social poisons are alcohol and 
syphilis. 

I do not think it advisable here to go into 
the subject in detail; previous preparation 
is necessary, and a mental habit must be 
built up which is able to accept definite 
truths and consider them in the right spirit. 



EUGENICS 145 

transforming knowledge into effective ac- 
tion. But from what I have already said 
it will be plain that the inquiries of Eugen- 
ics reach down to the very bases of human 
life. As the results of those researches be- 
come more widely known, the inevitable re- 
sult will be the enactment of laws designed 
to correct deteriorating influences. Wise 
laws of this kind, and their honest ad- 
ministration, would do much good ; but they 
cannot deal with the whole problem of men- 
tal, physical and moral health. Not laws, 
but men and women, must build up public 
opinion and develop private action if the 
results are to be vital and permanent; and 
the main hope lies in the spreading of es- 
sential knowledge amongst all classes, in- 
stead of confining it to a small and often 
powerless minority. 

The best time to begin to acquire' such 
knowledge is, of course, during childhood 
and early youth. It is almost impossible 
to commence too early, if the information 
is given by degrees, wisely, lovingly, com- 
prehendingly. In early years our brains 
are more plastic and impressionable, and 
what we learn then becomes a matter of 



146 MOTHER AND CHILD 

conviction, almost of conscience. What we 
have been taught — if we have been taught 
wisely and not narrowly — of good or evil, 
in youth, becomes second nature in later 
life. 

The principles of Eugenics are half at 
least of the modern Decalogue. Parents 
who are still ignorant must learn the essen- 
tials painstakingly, and then, to the best of 
their ability, with tact and judgment and a 
high sense of responsibility, impress them 
upon the minds of their children — both 
boys and girls. 

It is now known as surely as anything 
can be known that certain mental, moral and 
physical traits are transmitted from parents 
to children, and to later descendants. In- 
sanity, moral obliquity, criminal tendencies 
and mental defects are thus transmitted, and 
the laws under which they are so transmitted 
are beginning to be well understood. Care- 
ful study has been made of the family his- 
tories of hundreds of insane, feeble-minded, 
criminal and alcoholic inmates of public in- 
stitutions, and it has been made clear that 
the births of defective children follow settled 
laws. Our knowledge is now so accurate 



EUGENICS 147 

that it is possible to predict almost exactly 
the kind of children that will be born to 
parents whose heredity and mental habits 
are known. If both parents are defective, 
all their children will be defective. If one 
parent only is defective, a certain percent- 
age of the children will be defective. 

These things are no longer matters of 
conjecture, but of positive scientific knowl- 
edge. How shall we use this knowledge for 
the benefit of our children? First, try to 
make their environment such as will co-op- 
erate with nature and permit the normal 
development of the children ; and while you 
are developing strong and beautiful bodies, 
try to train the minds to keep pace with the 
physical development. Diet, exercise, play 
and education require the most intelligent 
and yet the most common-sense supervision. 
Give plenty of good, wholesome food, but 
teach clearly the evils of gluttony and fad- 
dism. Remember that in early life a sound 
body is more important than an over-culti- 
vated mind, with its possible consequences 
of nervous derangement. Be careful, there- 
fore, not to ruin the child's proper and har- 
monious development by premature and un- 



148 MOTHER AND CHILD 

duly severe educational efforts. Be patient. 
Teach the fundamentals quietly, thoroughly. 
In all things, try to preserve the ideal of 
normality, avoiding forced growth, excite- 
ment, unnecessary stimulus and straining. 

Most children are normal and inclined to 
play and romp ; but sometimes we see timid, 
gentle or diffident children who find it hard 
or even impossible to hold their own against 
stronger and more aggressive playfellows. 
Such children are often of rare and beauti- 
ful types mentally and spiritually. Their 
fine natures are jarred or hurt by the rela- 
tive crudeness, roughness and thoughtless- 
ness of other children of their own age, who 
cannot understand them and often persecute 
them. These remarks apply chiefly to boys 
of this type. Their bringing up is a matter 
of serious importance, and the intelHgence, 
or lack of it, shown by the parents means 
much for the future attitude of the diffident 
or backward child toward others. Such a 
boy is indeed fortunate if he has a father 
who possesses patience and discrimination. 
As a rule his diffidence and seeming cow- 
ardice indicate a mere lack of confidence' 
which could easily be given to him by a 



EUGENICS 149 

sympathetic and sensible father. What he 
needs is not protection from rough and rude 
boys, but self-confidence; and this must be 
instilled into him practically. He must be 
taught to use and believe in his own strength, 
to become self-reliant and thoroughly able 
to defend himself. This is not said to en- 
courage rowdyism in boys; but it is abso- 
lutely necessary to teach gentle and finely- 
strung boys to protect themselves and not 
to submit to the humiliation of being brow- 
beaten by bullies. There is no more blight- 
ing,^ and even fatal, handicap to a young 
man than lack of self-confidence — a reason- 
able and sound confidence in his physical 
ability to take care of himself. 

If you have provided for your children a 
good heredity and an environment which 
has permitted nature to give them strong, 
healthy bodies, the next duty is to educate 
them in the essential facts of life. It is not 
merely useless, it is utterly pernicious, to 
ignore sex conditions; and teaching should 
be begun while the mind of the child is plas- 
tic and pure, able to accept natural facts 
with perfect simplicity, and to absorb and 
incorporate in character the sense of beauty, 



150 MOTHER AND CHILD 

fitness and naturalness that will be asso- 
ciated with such truths by all healthy and 
decent men and women. A child can be 
taught the facts of love, union and reproduc- 
tion as simply as he can be taught his alpha- 
bet; he will accept unquestioningly the 
teaching that is given to him with insight 
and affection. The false shame that comes 
from the false secrecy so long habitual 
amongst adults, is entirely absent from a 
child whose nature has not been vitiated by 
wrong training, undesirable companions and 
an unhealthy environment. 

The best and most natural teaching is 
along biological lines. Begin very simply 
with the reproductive process in plant life, 
passing to the insect and lower animal life, 
thence to the higher animals, and finally, 
by natural and easy transition, to reproduc- 
tion in the human kingdom. This method 
of teaching sex relations has been tried by 
many teachers, and invariably with complete 
success. Sincere workers in this field have 
repeatedly told me of the wonderful im- 
provement in the minds, manners and sym- 
pathies of boys and girls fortunate enough 
to have had sex matters explained to them 



EUGENICS 151 

in this sane and simple way, instead of 
through the vile channels by which children, 
especially boys, usually get their perverted 
ideas of this supreme fact in physical nature. 

The important objects of sex knowledge 
for young people are : First, to enable them 
to understand themselves, their desires and 
passions, and to learn to control these in 
their relation to themselves and to others. 
Second, to enable them, as the lessons of 
childhood come to maturity and bear fruit, 
to bring more than blind and temporary 
attraction to the choice of their life-comrade. 
Third, by teaching them the truth and the 
essential beauty of nature, to safeguard 
them from the false or vicious hints and 
teaching of those whose minds are distorted, 
and who still regard the simple facts of 
natural life as unclean and impure. Fourth, 
to prevent, by the clear counsel that will 
supplement in youth the lessons of child- 
hood, the terrible afflictions of venereal 
disease. 

Morality is not an accident. It is the 
result of sound heredity, rational training, 
and healthy environment. 

Immorality, so long considered inevitable, 



152 MOTHER AND CHILD 

is no more natural in the race than con- 
sumption. But enlightened and persistent 
treatment is as necessary to eliminate the 
one disease as the other. 

Most parents are unaware that sexual 
immorality among school children is com- 
mon and widespread. Two factors are 
chiefly responsible — ignorance, due to the 
deplorable neglect of parents; and per- 
fectly natural curiosity as to sex matters. 
Not one only, but both of these causes of 
growing degeneration must be ascribed to 
parental neglect, indifference, dulness, or 
so-called modesty. Of all false conceptions, 
the false conception of modesty is the most 
deplorable. Parents who for any reason 
have neglected the supremely important, 
and indeed sacred duty of training their 
children to understand the primary facts 
of life, and essentially of sex life, are simply 
preparing the way for the corruption and 
degeneration of youth. The things which 
are forbidden or tabooed, without any lucid 
or convincing explanation, are invariably 
attractive in a morbid and almost irresistible 
way. No boy, and few girls, of spirit and 
strong personality, will be satisfied with 



EUGENICS 153 

vague and flimsy reasons for the prohibition 
of impulses and pleasures which they soon 
learn are occupying the better part of the 
attention of most people. Rebuffed by their 
" modest " parents, they will find out from 
other and secret or insidious sources. If 
they get into trouble, their parents are to 
blame. 

It is deplorable that owing to the perverse 
stupidity of many parents, the youth of both 
sexes are usually denied sex education from 
their most natural teachers, so that their 
first and most lasting impressions of sex 
relations, derived from ignorant or vicious 
sources, are almost hopelessly distorted and 
perverted. Instead of the true conception 
of sex as the most profound, important and 
beautiful fact in human life, there is sub- 
stituted a conception involving secrecy, 
shame and " nastiness." I wish to empha- 
size, as emphatically as I can, the entire 
responsibility of the parents. A true and 
noble view of sex relations broadens and 
ennobles all life. A perverted and abnormal 
view degrades or obscures the higher self 
and shuts the door against all that is most 
beautiful and inspiring. 



154 MOTHER AND CHILD 

The foundation of sex education must be 
placed in utter confidence between parent 
and child. Very gradually, the child must 
be guided to see that there is nothing secret 
or shameworthy in the functions of the body. 
True modesty must be sacredly safeguarded, 
but false modesty must not be allowed to 
develop. It is not natural; it is merely a 
perversion due to distorted and unhealthy 
conventions. When the child has accepted 
unquestioningly, as it will accept, the true, 
clear-eyed view of its own body and the facts 
of human life, more definite and detailed 
instruction can be given. The meaning of 
puberty should be explained in due time, 
and then, carefully and wisely, the tempta- 
tions and inevitable penalties of promiscu- 
ous sexual intercourse must be unfolded. 
Every year, the venereal diseases, syphilis 
and gonorrhoea, ruin tens of thousands of 
lives, and sterilize and deteriorate the race. 
No boy or girl should pass through the years 
of youth without being made familiar with 
these fundamental facts, as naturally and 
obviously as they are made familiar with 
the thousand and one facts of general knowl- 
edge and daily custom. But far too often 



EUGENICS 155 

we find a boy who is considered fit to grapple 
with the Binomial Theorem and the laws 
of chemical combination, or a girl who is 
studying the psychology of apperception or 
wrestling with the intricacies of the Aristo- 
telian Sorites, utterly and wickedly ignorant 
of the elementary processes of hfe — except 
for vicious and corrosive suggestions from 
the crude and unbalanced prompters of 
evil. These are always only too eager to 
convey in their own way the information 
withheld by the parent or guardian. Defi- 
nite instruction in sex matters must be no 
longer a matter of individual choice or 
neglect. It is an absolute and fundamental 
duty, on the faithful observance of which de- 
pends almost the whole future of the child. 
Children who have been wisely brought 
up in the understanding of the teachings of 
Eugenics, and in the fulfilment of those 
teachings in their daily life, will reach ma- 
turity with strong and definite convictions 
as to the importance of keeping up the stan- 
dard of the race, or, rather, of ensuring its 
continued progress and betterment. They 
will realize their own responsibility to pos- 
terity. They will learn to distinguish be- 



156 MOTHER AND CHILD 

tween true and false love, between tem- 
porary attraction and permanent affection. 
Those who are under the influence of pas- 
sion do not usually reflect as to the future 
consequences, to themselves or to others; 
but those who have been taught that their 
future life-comrade should be not only 
lovable in himself or herself, but entirely fit 
to be the parent of healthy children, will at 
least be more likely to choose well and hap- 
pily, and less likely to be carried away by 
impulse and passion, than those who do not 
understand the supreme significance of 
Eugenics. 

It has been shown that mental defects 
may " skip " one generation, under certain 
conditions, but reappear in the next. Hence 
it is unwise to marry a member of a family 
in which there is any record of insanity, 
feeble-mindedness, epilepsy, criminality, or 
marked eccentricity. Marriages of people 
of good stock with those associated with such 
defects are strongly liable to yield at least 
one or more defective children. No tem- 
porary impulse should be allowed to over- 
master the sense of duty and prepare the way 
for future intolerable remorse. 



EUGENICS 157 

With regard to alcohol, there can be no 
temporizing, from the eugenic point of view. 
While many men who indulge too freely 
during youth do straighten up more or less 
completely in after life, the majority do not. 
Alcoholic indulgence is playing with fire for 
even the best kind of youth. Even in moder- 
ate quantities, alcohol invariably lowers the 
coefficient of efficiency, retards the mental 
processes, dulls the keenness of vision and 
hearing, diminishes the sensitiveness of touch 
and smell; in a word, it interferes with all 
physical and mental action, and is thus dis- 
tinctly a poisonous and habit-producing 
drug. 

It is important to remember that normal 
individuals do not naturally and of choice 
indulge to any large extent in alcohol — 
unless they have unfortunately been thrown 
frequently into the company of undesirable 
self-styled " sports " ; and even the acquies- 
cence in this kind of companionship indi- 
cates some degree of mental inferiority. 
Hence young men who are frequently seen 
under the influence of alcohol, or with the 
odor of it upon their persons, may, as a 
general rule, be classed as belonging to in- 



158 MOTHER AND CHILD 

ferior types, either through heredity or 
environment. A young girl is therefore 
taking a long and dangerous chance when 
she marries an habitual drinker. Such a 
man is deteriorating, slowly, perhaps, but 
surely, in all ways — morally, mentally and 
physically. This deterioration by means of 
alcoholism is transmissible to offspring, and 
the children of a drunkard are apt to inherit 
all of their father's bad tendencies and weak- 
nesses, with little, perhaps, of his original 
strength, which has been altogether vitiated 
by the poison. Nearly every girl who falls 
in love with a " drinker " tries to make an 
exception in her own case, and has confi- 
dence in her ability to reform the man she 
admires for his other qualities. Some mil- 
lions of women, altogether, have married 
with this idea, looking forward confidently 
to the future; but a baby could count the 
number who have not paid the penalty that 
they invited — a wrecked life and a dreary 
home. 

It is advisable here to refer to marriages 
between cousins. Eugenics has thrown a 
new light on this subject. When two de- 
fectives marry, all their defects are empha- 



EUGENICS 159 

sized in their children. When sound per- 
sons of good stock marry, their good quaH- 
ties are emphasized as they are transmitted 
to their children. Here is the explanation 
of the common opinion that the children of 
parents who are cousins are apt to be de- 
fective. When cousins marry, their chil- 
dren are prone to inherit and combine, in 
a marked degree, the family traits, good or 
bad. Hence, when cousins of a defective or 
neurotic family marry, they will probably 
produce children in whom the worst ten- 
dencies of the family will reappear, empha- 
sized. When normal cousins of good stock 
marry, they will have good, or even superior, 
children. 

It is quite clear from this that cousins 
should not marry unless they are themselves 
normal, with altogether sound heredity. 

Strong corroboration on a large scale of 
the principle that inbreeding tends to de- 
terioration by emphasis of defectiveness is 
shown in the Jewish race. The latest New 
York statistics reveal that the Jews furnish 
by far the largest racial percentage of the 
forms of insanity and mental deficiency 
which have their basis in constitutional in- 



160 MOTHER AND CHILD 

f eriority. This must be ascribed to in breed- 
ing, especially as the Jews present almost 
no cases of mental disease or defects de- 
pending upon syphilis and alcoholism. 

The golden rule of medicine is, Preven- 
tion is better than cure. The best way of 
curing disease is to prevent it. The best 
and most certain way to improve the race 
is to see that we have no defective children. 
Defectives and criminals should not be al- 
lowed to marry, unless previously sterilized 
by a surgical operation. As a matter of 
fact, the laws of several of our States now 
provide for the sterilization of habitual 
criminals, for the protection and purifica- 
tion of the race. 

Instruct your children in the principles 
of Eugenics. Give them the knowledge that 
will help to make them wiser and stronger 
and better men and women ; that will guide 
them to a sure happiness in marriage and 
bless their homes with the noblest kind of 
children. 



XII 

MEDICAL INSPECTION OF SCHOOL 
CHILDREN 

THE importance of medical inspection 
of school children was not realized 
some years ago. Among the educa- 
tors of our country very little thought was 
given to what is now one of the essential 
features of school requirements. To-day 
America stands pre-eminently supreme in 
this respect. I think it important to refer 
to the subject, briefly, in a book like this, 
since every individual home, of whatever 
class, is vitally interested in the general 
health of the nation's children. 

It is instructive to note what is going on 
in other countries in certain lines of this 
work, and what progress is being made. In 
Prussia the Government insists upon regu- 
lar medical inspection. Every pupil is ex- 
amined physically; heights, weights, and 
all abnormalities are recorded. The doctor 



162 MOTHER AND CHILD 

makes a monthly visit, and at the beginning 
of each school year the complete examina- 
tion is repeated. This, of course, is admir- 
able and has been of enormous value to the 
health of the Prussian nation. 

In England, as late as 1905, there was no 
thorough examination embodying reliable 
scientific data with regard to the pupils in 
the elementary public schools. It is true 
there was a medical inspection, but it was a 
cursory examination rather than a complete, 
systematized inquiry carrying on scientific 
work under the guidance of paid medical 
men. There has been a welcome change, 
however, and in England to-day a very 
complete system has been adopted, showing 
that our British cousins have made distinct 
progress in a few years. For instance. Dr. 
Kerr, Medical Officer to the London School 
Board, tested the eyes of more than a thou- 
sand children three times over. The results 
of this work have been of inestimable value. 
Again, the British Dental Association has 
also made investigations regarding the teeth 
of school children. The exact knowledge 
these dental practitioners possess regarding 
the condition of the teeth at different ages 



SCHOOL INSPECTION 163 

is very interesting. It has been demonstra- 
ted that decay of the teeth begins at about 
the age of four years, and that unless the 
teeth are well cared for even at an early 
period of childhood, eight or ten permanent 
teeth are either ruined or lost not many years 
after they are acquired. It is obvious that 
children in public schools should have medi- 
cal and dental supervision, and instruction 
should be given to parents regarding their 
children's teeth.^ 

The inspections carried on in our own 
country are somewhat different. They are 
more beneficial to the health of the children 
inasmuch as we make more completely or- 
ganized examinations and have a more rigid 
system, to which we adhere. 

Through this inspection work of the phy- 
sicians of the Board of New York City, the 

^ *' School time is the period at which the people's 
health can be most easily and effectively dealt with 
by public authority. There is then an opportunity 
of ascertaining and watching the condition of children 
from day to day, and bringing influences to bear to 
improve their health, which would be impossible at 
any other time of life." — Medical Inspection of 
School Children. Sir John E. Gorst in " The Chil- 
dren of the Nation." 



164 MOTHER AND CHILD 

health of the New York school child has 
been placed upon a solid physical basis. 
There is no longer need to question what is 
wrong with a deficient child, for this rou- 
tine medical inspection, practised by the 
most competent men, has so systematized 
the work that complete information is avail- 
able for both teachers and parents. Inspec- 
tors visit the schools and diagnose every ail- 
ment which is detrimental to a child's wel- 
fare, physical and mental. Diseases and 
defects are noted and the parents promptly 
advised. Sound advice and instruction are 
given gratis. 

The subject is so important that I shall 
give here a brief summary of the regime 
carried out by the New York Board of 
Health. Adequate medical inspection of 
school children is essential to the well-being 
of the child and the community; and all 
parents should realize the nature of the work 
that is being done. 

Here is the working plan of the system of 
medical inspection and examination of 
school children in the .City of New York, 
taken from the pamphlet issued by the 
Board of Health of the city. 



SCHOOL INSPECTION 165 

History. 

March, 1897: Appointment of one hun- 
dred and fifty Medical Inspectors at a salary 
of $30.00 per month. Morning inspection 
only required. 

September, 1902: System elaborated to 
include morning inspection, routine weekly 
inspection of children in the class-rooms and 
visiting of absentees at their homes. Salary 
of Inspectors increased to $100.00 per 
month. 

December 1st, 1902: Appointment of a 
Corps of Trained Nurses, at a salary of 
$75.00 per month. 

December 16th, 1902: Establishment of a 
Hospital and Dispensary, for the exclusive 
treatment of Trachoma. 

March, 1905: Inception of a complete 
physical examination of each school child. 

Objects. 

1. Repeated and systematic inspection 

and examination of school children 
to determine the presence of infec- 
tious or contagious disease. 

2. Exclusion from school attendance of 



166 MOTHER AND CHILD 

all children with acute contagious 
disease. 

3. Subsequent control of the case, with 

isolation of the patient and disinfec- 
tion of the living apartments after 
the termination of the illness. 

4. Control and treatment of minor con- 

tagious affections, permitting the 
child to remain in attendance at 
school. 

5. Information of unreported cases of 

contagious disease occurring in 
school children at their homes. 

6. Exclusion from school attendance of 

those children in whose families 
there exists a contagious disease. 

7. Complete physical examination of each 

school child, for the purpose of 
determining the existence of non- 
contagious affections, and advising 
treatment of the same. 

Schools Visited. 

Public Schools, Parochial Schools, Ameri- 
can Female Guardian Society Schools, 
Children's Aid Society Schools and Kin- 
dergartens. 



SCHOOL INSPECTION 167 

Force. 

1. Assistant Chief Medical Inspector, in 

charge of the work. 

2. Corps of Medical Inspectors, all of 

whom are physicians. 

3. Supervising Nurse, in direct charge 

of the nurses. 

4. Corps of Trained Nurses. 

Working Plan of the System. 
Duties of Medical Inspectors, 

Each Inspector is assigned to duty in 
a group of schools. 

Morning Inspection. 

The Inspector visits each school in his 
charge before ten o'clock each morn- 
ing, and examines, in a room set 
apart for the purpose, the following : 

(a) All children isolated by the teach- 

ers as suspected cases of conta- 
gious diseases. 

(b) All children who have been absent 

from school. 

(c) Children returning after previous 

exclusion. 



168 MOTHER AND CHILD 

(d) Children previously ordered under 

treatment. 

(e) Children referred by the school 

nurse for diagnosis. 

(f) All affected children showing no 

evidence of treatment. 

Cases to he Eoocluded. 

Children showing signs or symptoms of 
small-pox, diphtheria, scarlet fever, 
measles, chicken-pox, whooping 
cough or mumps. 

Cultures to be taken in all cases of sore 
throat to determine the presence of 
diphtheria bacillus. 

Cases of small-pox, scarlet fever and 
measles to be reported, by telephone, 
to the Central Office, so that a diag- 
nostician may at once visit the case, 
confirm the diagnosis and order 
isolation. In these cases a postal 
card must be sent from the Division 
of Contagious Diseases to the Prin- 
cipal of the school informing him, or 
her, of the presence of contagious 
disease, with instructions that no 
member of the family be allowed to 



SCHOOL INSPECTION 169 

attend school until the termination 
of the case. 

The working plan is admirable, as has 
been proved by the remarkable results ob- 
tained by the health authorities. The card 
index system in use is very valuable. Com- 
plete reports are sent in daily, on a printed 
form, by the Medical Inspectors and the 
Nurses, while there are special forms for 
special cases. In addition, the Departinent 
of Health issues notifications to parents and 
from time to time distributes valuable prin- 
ted directions with regard to such matters 
as the care of the mouth and teeth, of the 
hair, etc. 

I have given these details because parents 
do not yet realize what the city government 
is doing for their children. To-day a child 
can go to the public schools and get an ex- 
cellent elementary education absolutely free. 
Its books and working material are free, 
and its health is taken care of without pay- 
ment, though a complete and expensive 
organization is required for the purpose. 
Strangely, some unthinking people resent 
this medical supervision as an intrusion 



170 MOTHER AND CHILD 

upon their rights. If they understood fully 
the supreme value to their children, and con- 
sequently to themselves, of the work that is 
so conscientiously carried out for their bene- 
fit, they would assist in every possible way 
to maintain the effectiveness of this most 
vital part of public and public-spirited 
work. 



XIII 

COMMON SENSE 

IN the preceding chapters I have called 
attention to the simpler facts of health 
and ill-health with which every mother 
should be fully acquainted. I have little 
more to add in this book, which deals only 
with conditions that affect, or are Uable to 
affect, every home and every parent; but 
not with too technical matters, or with the 
science of medicine in those more difficult 
developments which must be left entirely to 
the trained physician. 

But I may add one final plea for Common 
Sense — " God's Own Common Sense," as 
Kipling calls it. Far too many of us travel 
through life burdened with prejudices and 
superstitions that we are unwilling to dis- 
card, even though we half -recognize their 
futility. We accept the fret and fever of 
modern life; the new cults, perhaps, and 



172 MOTHER AND CHILD 

the new fads; but we do not always accept 
the Philosophy of Common Sense which is 
the essential contribution of modern thought 
to modern life. 

All through this book, I have tried to 
keep in the forefront the idea of normality. 
There is no condition in life that can be 
bettered by the loss of self-control, no prob- 
lem that can be solved by forgetting the 
simple rules of reason, no perplexity that 
can be overcome by yielding to despondency 
or hysterical excitement. As poise is half at 
least of the secret of success in business 
relations and of happiness in personal rela- 
tions, so is normality far more than half the 
secret of poise. In the big emergencies that 
come to most of us, and in the little emer- 
gencies that come to all of us, there is in- 
cessant need for poise, for normality, for 
common sense; and in this trinity in unity 
may be found the mainstay of effective ac- 
tion and effective living. 

Progress is essential, and it is entirely 
right that the trained mind should consider 
and test new ideas, looking always for the 
something worth while that will move things 
forward and increase the sum of human 



COMMON SENSE 173 

efficiency and happiness. But one should 
be careful, jealously careful, to avoid fads 
and ephemeral mental playthings. In 
science and in religion, and in attempted 
combinations of both, there are exploited 
almost every day unbalanced theories, crude 
creeds, dangerous and destructive dogmas. 
Sometimes these are put forward with sin- 
cerity; often there is a grain of truth in 
them — sufficient to deceive the credulous 
and persuade them to accept also the mass 
of positive falsity or doubtful suggestion. 
But the majority are due to the fertile 
imaginations of conscious self-seekers, eager 
to commercialize for their own profit the 
natural desire of men and women for fur- 
ther knowledge, or the unnatural desire for 
hectic excitement and corybantic creeds. If 
you wish to lead a normal, healthy and use- 
ful life, avoid the " quacks " of every kind 
and degree; accept nothing that cannot 
justify itself on rational grounds, and add 
in support the proof of repeated and clear 
experience. 

I shall not enter here into the merits or 
demerits of the different cults that have 
come swiftly or gradually into notoriety — 



174 MOTHER AND CHILD 

Christian Science, Osteopathy, Allopathy, 
Eclecticism, and so forth. A physician 
might be suspected of at least a little bias 
in favor of his own order. But, neverthe- 
less, the experience of a physician who cares 
only for the truth, wherever he may find it, 
should carry sufficient authoritativeness for 
normal people; and my experience shows 
me unmistakably that what cannot be given 
by modern medicine for the relief or cure 
of disease and injury, can certainly not be 
obtained from any other source. The science 
of healing has made very wonderful ad- 
vances during recent years; it has been 
built up by the researches of a large number 
of men whose names will be forever re- 
membered, and by the self-sacrifice and 
devotion of a still larger number whose 
names are unrecorded except in the memo- 
ries of their friends, but whose work will 
endure and add to the happiness and 
well-being of the race so long as the race 
endures. 

I feel that this little digression is due to 
those who are fighting throughout the world 
the battle of normality against abnormality, 
of health against disease. On the battlefield 



COMMON SENSE 175 

and in the slums, in the malarial tropics and 
the frigid north, in the Panama Canal Zone, 
in the cholera-stricken and famine-haunted 
districts of India, you will find them quietly 
doing their daily work, as you will find them 
in the bacteriological laboratories of great 
cities, examining infected tissue, cancerous 
growths or tubercular sputum. And when 
you avail yourself of their services, and pay 
for those services, will you remember that 
this is not altogether and simply a commer- 
cial transaction, but that on both sides, be- 
yond the personal consideration of the mo- 
ment, there is the obligation that rests upon 
all human beings to maintain the purity and 
health of the race, at whatever personal cost ? 
Your child is not only your own child, for 
whom you would sacrifice your life. He is 
the child of the nation. And the physician 
whom you call in is not merely your own 
private family physician. He is the servant 
of the nation also; and the skill and 
knowledge that he derives from those who 
have led the van of medical progress must 
be used in the service of humanity as 
a whole, as well as of the individual as a 
unit. 



176 MOTHER AND CHILD 

And so, though you will meet with in- 
competent physicians, who are not up-to- 
date, — as you will meet with incompetent 
or careless lawyers, — when you have chosen 
your own family physician with care and 
discretion, avail yourself of his services when 
you need them, remembering that he in- 
herits the legacies bequeathed to medical 
science by tens of thousands of patient in- 
vestigators. Co-operate with him, and do 
your share of the work in hand by being 
normal yourself, and ensuring normality and 
order in your household. 

The old legend tells us that in the time 
of peace we should prepare for war. But 
so far as medicine is concerned, we can go 
a step further. In the time of health and 
freedom from anxiety, try to carry on your 
preparations and regulate your hfe so that 
there shall be no war — no disease. The 
daily observance of hygienic principles, the 
wise and comprehending training of your 
children in the truths of Eugenics, and the 
resolve always to be guided by common 
sense, to build up and preserve poise, to be 
normal, avoiding the morbid, the hectic, the 
irrational, the excitable — if you will do 



COMMON SENSE 177 

this, you will find generally that there is 
little left to do. 

Be normal. That is the alpha and omega 
of personal conduct. I began my httle book 
with that advice, and with that advice I 
close it. 



APPENDIX 
A 

A Few Don'ts 

1. Never allow a child in the nursery or 

in a kitchen within the reach of hot 
water — kettles — teapots — scald- 
ing clothing — boiling fruits, etc. 

2. Never allow a child to climb upon a 

table containing an oil lamp. 

3. Never have a fire in the nursery unless 

it is well screened. Remember 
to keep children away from all fires, 
imless guarded. 

4. Never allow a child to play with 

matches. 

5. Never allow a child to put things into 

its mouth. 

6. Never allow a child to continue to suck 

its thumb. 

7. Never use a " pacifier " — the practice 

is bad. 



180 APPENDIX 

8. Never take suggestions from neighbors 

regarding the feeding or treatment 
of your child. Consult an able 
physician. 

9. Never forget that in acute illness a 

dose of castor oil given early is the 
most useful remedy. 

10. But never allow castor oil or any cathar- 

tic to be given to a child which has 
swallowed a foreign body, such as a 
pin, beads or a marble. Do not allow 
liquids of any kind to be adminis- 
tered. Slight constipation in such a 
case is more desired than loose bowels. 
Let the child chew and swallow dry 
stale bread, and send immediately 
for a physician. 

11. Never allow a nurse to give a rectal 

injection or medication of any kind 
without the knowledge of a parent. 

12. Never allow a bottle of medicine in a 

nursery within the reach of children; 
and never allow any medicine to 
stand unless correctly labelled. 

13. Never allow Poisons to be put with 

other medicines. Lysol, Bichloride 
of Mercury, Paregoric, and drugs of 



APPENDIX 181 

that description, should be kept 
locked up alone. 

14. Never keep a patent medicine in the 

house. 

15. Never encourage your children to kiss 

others than their parents. 

16. Never neglect to call a physician when 

a child is really sick and beyond your 
management. 

17. Never allow a physician to prescribe 

and give instructions to the nurse or 
parent and leave the house, without 
your being certain that the directions 
are thoroughly understood. If there 
is any qjiestion as to what was said 
and any doubt in your mind regard- 
ing the instructions, ask to have them 
repeated. Every real physician is 
only too anxious to be thoroughly 
understood and to have his instruc- 
tions carried out to the letter. 

18. Never employ a physician or a nurse 

who is an habitual drinker. They 
are dangerously unreliable. 

19. Never allow the nurse to neglect your 

child in any way. Be sure to call 
her attention to any seeming neglect. 



182 APPENDIX 

A woman who cannot manage a 
nurse quietly but effectively is gen- 
erally a poor mother. 

20. Never allow cruelty to be practised 

upon your children. A nurse who is 
not refined and patient with children 
should be instantly dismissed. 

21. Never permit your children to eat 

candy, cookies and such things with- 
out your knowledge and permission. 

22. Never fall into the habit of bribing 

your children to do what they should 
do. 

23. Never leave the entire care of your 

children to a nurse, no matter how 
devoted she may be. A mother's 
supervision of feeding, training and 
education is an absolute necessity in 
the nursery. 

24. Never forget that little things in child- 

hood mean big things in later years. 

25. Never scold your child for breaking 

something if you would not have re- 
proved him for touching it. The 
breaking is an accident. 

26. Never scold at all, for anything. Point 

out what is wrong, quietly. If there 



APPENDIX 183 

must be punishment, let the child see 
that this punishment comes without 
anger, as an inevitable result of his 
action — but never as a result of 
mood on the part of his parent. 

27. Never draw attention to details without 

leaving in the child's mind a sense of 
the general principle involved. 

28. Never over-dress a boy, or let him have 

long hair, or try to use him as an 
ornamental pet. Let him start out 
with a proper chance to be a man. 

29. Never forget that you cannot expect a 

child to be thoughtful, considerate 
and happy, if you yourself are 
thoughtless, careless, fretful, irritable 
or melancholy. It is not enough to 
teach theories. You must illustrate 
them by consistent practice. 

30. Never forget to use common sense in- 

stead of nonsense. Preserve poise in 
all the relations of life. Be normal. 



B 



" First Aid " Requisites for the 
House 

IT must be remembered that family treat- 
ment can only be carried out when the 
necessities of the nursery are at hand. 
Below is given a fairly complete medical 
outfit, with which every family in which 
there are children, and especially those in 
the country, should be provided. If a phy- 
sician is called in haste and he finds the medi- 
cine cupboard scientifically stocked, it may 
be of inestimable value to him, for no doctor 
can at all times carry with him every article 
that may possibly be required for each in- 
dividual case. Many a medical and surgi- 
cal cure has been made possible by articles 
from the family medicine chest. 

1. Two clinical thermometers — one to 
be kept for the mouth, the other 
for rectal use. 



APPENDIX 185 

2. Two-quart douche and hot water 

bag, with the necessary appHances, 
for adult and child. 

3. A graduated " medicine glass " and 

a " dropper." 

4. One dozen assorted bandages. 

5. Two half-pound boxes of absorbent 

cotton. 

6. Five yards of plain sterile gauze 

(Johnson & Johnson). 

7. A packet of plain lint (Johnson & 

Johnson). 

8. A small box of " oiled silk/' (John- 

son & Johnson). 

9. One yard of rubber tubing. 
10. A box of mustard plasters. 

Keep in well-labelled bottles 2 to 4 ounces 
of the following: 

Lysol 

Castor Oil 

Alcohol 

Listerine 

Glycerine 

Turpentine 

Whiskey 

Spirits of Ammonia 



186 APPENDIX 

Linseed Oil 
Hunyadi Janos water 

In boxes should be kept : 

Boracic Acid 
Bicarbonate of Soda 
Epsom Salts and Rochelle Salts 
Powdered Alum 
Talcum Toilet Powder 
Two three-inch plaster bandages 
(J. & J.) 

The following medicines are useful to 
have in the house and should be carefully 
labelled : 

Compound cathartic pills 

Quinine pills — 5 grains 

Dover's Powders — 2 to 5 grains 

Syrup of Ipecac 

Phenacetin — 1 to 5 grains 

Asperin — 5 grains 

" Sun " Cholera Mixture 

Paregoric 

Compound Tincture Benzoin 

Sterile Vaseline and " Ky " should be 
kept in tubes. 



INDEX 



Adenoids, 138, 139 

Alcohol and alcoholism, 71, 72, 

73, 144, 157, 158 
Alcoholism among Jews, 160 
Anaesthetics, preparation for, 

139, 140 
Appendicitis, 141 
Artificial feeding for babies, 52, 

53, 54 
Atwater, Prof. W. O., 63 
Automobiling forbidden during 

pregnancy, 9, 10 

Bathing the child, 37 

Baths, sitz, 7 

Bed, how to prepare for child- 
birth, 21 et seq. 

Beds for nursery, 36 

Behnke, Mrs. E., 114 

Bleeding, how to stop, 135, 136 

Boils, 118, 119, 120, 121 

Books for children, 41, 42, 43, 
44 

Brain of a child, 104 

Breasts, caked, 12 

care of, 11, 12, 49, 50, 51 

Bribing children, 182 

Bronchitis, 79, 80, 81 

Caked breasts, 12 

Campbell, Helen Y., 16, 25, 48 

" Care and Feedmg of Children," 

54 
Chicken pox, 81, 82 



Children, how to train, 1^7 et seq. 
and sex teaching, 149 

et seq. 
"Children of the Nation, The," 

47, 163 
Chorea, 111, 112, 113 
Clothing during pregnancy, 13 
Colostrum, 20, 45 
Confinement, when to expect, 

17, 18, 19, 22, 23 
symptoms of impending, 

22, 23 
Constipation during pregnancy, 

14 
Craddock, Mrs. H. C, 40 
Crib for baby, the best kind, 36 
Croup, 83, 84, 85 

kettle, 85 

membranous, 85, 86, 87 



Cuts, 135, 136, 137 

Decay of teeth, 163 
Diet in sickness, 61 

scheme, 58, 59, 60, 61, 62 



Diffident children, 148, 149 
Diphtheria, 85, 86, 87 
Dr. Ely's table, 17, 18 
"Dont's," 179 

Earache, 121, 122 
Ely's table, 17, 18 
Eugenics, 144 et seq. 
Exercise during pregnancy, 9, 
10, 11 



188 



INDEX 



Feeding the child, 45 et seq. 

artificial, for babies, 52, 

53, 54 

forced, 73 

ia disease, 65 et seq. 



First-aid requisites, 184, 185, 

186 
First babies, 19 

Foods forbidden for children, 62 
Forced feeding, 73 

Globus hystericus, 107 
Gonorrhoea, 154 
Gorst, Sir J. E., 47, 163 
Grippe, La, 88, 89 

Head lice, 122, 123, 124 
Hemorrhage, 134, 135, 136, 137 
Heredity, 146, 147, 148, 149 
Holt croup kettle, 85 
Hysteria, 106, 107, 108 

Inbreeding, 159, 160 
Influenza, 87, 88, 89 

complications of, 88 

Intercourse during pregnancy, 

12 
Inverted nipples, 11 

Kerley, Dr., 38, 54 
Kissing, dangers of, 181 
Koplick's sign, 91 

Labor, 23 

Lewis, Dr. H. E., 61 

Lightening, 20 

Marriages between cousins, 158, 
159 

unsuitable, 156, 158 

Mastication, 55 
Measles, 89, 90, 91, 92 



Medical inspection of school 
children, 161 et seq. 

New York system. 



165 et seq. 
Mediciues to be kept in the 

house, 185, 186 
Melancholy, 116 
Membranous croup, 85, 86, 87 
Menstruation during pregnancy, 

19 
Mental fatigue, 116 
Milk "Dont's," 56, 57 
Mother's milk, 45, 46, 47, 48, 

49 
Mumps, 92, 93, 94 

Naegele's rule, 17 

Nausea during pregnancy, 8 

Nervous children, 104 

diseases of childhood, 102 



et seq. 
Nervousness, 116 
Nervous system of a child, 103 
Neuralgia, 125, 126, 127, 128 
Neurasthenia, 106, 108, 109, 

110 
Night terrors, 110, 111 
Nipple shield, 51 
Nipples, inverted, 11 
Nose bleed, 128, 129 
Nurse, danger of incompetence, 

25, 26, 27 

how to choose, 25 et seq. 

— — necessary qualifications, 33 
supervision of, 181, 182 



Nursery, furniture in, 34, 35, 36, 
39, 60 

how to arrange, 34 et seq. 

how to heat, 38, 39 

temperature of, 37 

ventilation of, 38 

Nursing intervals, 57 



INDEX 



189 



Oak rash, 129, 130, 131 
Operations, simple, 134 et seq. 

Parotid gland, 93 

Parotitis, 93 

Patent medicines, 181 

Pattee, A. F., 69 

Pavor nocturnus, 110, 111 

Photophobia, 90 

Pictures for children, 43, 44 

Pneumonia, 79, 80, 81 

Poison ivy, 129, 130, 131 

Poisons, to be locked up, 180, 
181 

"Practical Dietetics," 63, 67, 72 

"Practical Dietetics, with Ref- 
erence to Diet in Disease," 69 

"Practical Motherhood," 16, 
25, 48 

Pregnancy, automobiling for- 
bidden during, 9, 10 

clothing during, 13 

exercise during, 9, 10, 11 

intercourse during, 12 

menstruation during, 19 

nausea during, 8 

physical changes during, 

19 et seq. 

proper treatment during. 



3 et seq. 
Prickly heat, 131 
Punctuality in meals, 69 

Quickening, 20 

Rest during pregnancy, 13, 14 
Ringworm, 132 



St. Vitus's Dance, 111, 112, 

113 
Scarlatina and scarlet fever, 94, 

95, 96, 97 
School children, medical and 

dental examination of, 161 

et seq. 
Scripture, Dr. E. W., 114 
Sex teaching for children, 149 

et seq. 
" Short Talks with Yoimg Moth- 
ers," 38, 54 
"Show, the," 23 
Sitz baths, 7 
Sprue, 132, 133 
Stammering, 113, 114, 115 
Steam heat, 38, 39 
Stomach troubles, 77, 78 
Swallowed pin, etc., what to do, 

180 
Syphilis, 144, 154 
among Jews, 160 



Teeth, decay of, 163 
Thompson, Dr. J., 104 

Prof. W. G., 63, 67, 72 



Thrush, 132, 133 
Tonsilitis, 97, 98, 99 
Tonsils, removal of, 138, 139 
"Training of Children, The," 40 

Varicella, 81 

Weir Mitchell treatment for 

neurasthenia, 109, 110 
Whooping cough, 99, 100, 101 



OCT 6 1918 



LIBRARY OF CONGRg^^^ 



022 216 366 3 



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